Efficacy of laminoplasty and bone graft in the treatment of multilevel intraspinal tumor

Objective To investigate the clinical effect of laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors. Methods Retrospectively review the clinical data of 35 patients suffering multiple segmental intraspinal tumors, who underwent the laminoplasty with bone grafting for intraspinal tumor resection in Department of Neurosurgery, Clinical Medical College of Yangzhou University, from June 2013 to May 2016. Observation indicators: (1) surgical and postoperative recovery situations, including tumor resection, number of lamina reset, tumor pathological results, clinical efficacy evaluation, complications, etc; (2) follow-up situations, including spinal stability evaluation, rate of bone graft fusion, tumor recurrence. Follow-up using outpatient examination and telephone interview was performed by the end of December 2017. Results (1) Surgical and postoperative recovery situations: of the 35 patients, 31 achieved total tumor resection, 3 subtotal tumor resection and 1 partial tumor resection. There were no spinal dura mater injuries when laminectomy was performed, and 84 laminae were repositioned and implanted. The neurological function of the spinal cord was evaluated based on McCormick scoring system: 32 cases were improved and 3 cases were controlled. Incision healing was bad in 2 patients, and cerebrospinal fluid leakage occurred in 1 case, which all recovered after treatment. (2) Follow-up situations: all the 35 patients were followed up for 8 to 36 months, with a median time of 14.2 months. Imaging examination more than 6 months after operation: no spinal instability was found in standing spine X-ray examination; CT scan showed a total of 142 sides in the 84 vertebral plates (168 sides) had achieved bone fusion, the fusion rate was 84.5%, and no titanium nail removal and connecting piece shift was found; MRI showed no tumor recurrence in all patients. Conclusion Use of the laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors can achieve good clinical efficacy, high fusion rate for resected laminae and satisfactory spinal stability. Key words: Spinal canal; Perioperative period; Laminoplasty; Bone grafting; Intraspinal tumor