Analysis Of Postoperative Spinal Stability After Laminectomy And Laminoplasty For Intraspinal Tumor

Objective:To compare the effects of laminectomy and laminoplasty on the operation time,blood loss,postoperative hospital stay,postoperative complications,neurological function,and spinal stability of intraspinal tumors.To provide clinical evidence and guidance for reducing postoperative complications of intraspinal tumors,improving postoperative neurological recovery,and improving spinal stability.Methods:This is a retrospective review of surgical treatment with either laminectomy or laminoplasty done for patients with intraspinal tumors in the First Affiliated Hospital of Zhejiang University Medical College.A total of 74 cases of parallel intraspinal tumor resection were performed from January 2014 to December 2017 in the hospital.The clinical data of the patients were retrospectively analyzed,especially neurological function score and spinal stability.Results:Of the 74 cases,36 were male and 38 were female,aged 12-80 years,with an average of 50.36 years.There were 35 patients in the laminectomy group and 39 patients in the laminoplasty group.There was no significant difference in gender and age between the two groups(P>0.05).There was no significant difference in the operation time,intraoperative blood loss,and postoperative hospital stay in the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The IJOA(Japanese Orthopaedic Association,Japanese Orthopaedic Association)scores were significantly improved after operation(P<0.05).There was no significant difference in the improvement rate of IJOA score between the two groups(P=0.473),but the improvement rate of IJOA score of laminoplasty in cervical segmental tumors was significantly better than laminectomy(P=0.036).There was no significant difference incidence of spinal instability in each segment(P>0.05).When the surgical segment was≥3,the incidence of spinal instability in laminectomy was significantly higher than that of laminoplasty,but there was no statistical difference(P=0.28).Conclusion:This retrospective evaluation demonstrates laminoplasty not to be more or less likely to have any better neurological function outcome expect cervical intraspinal tumors.Laminoplasty was not associated with lower incidence of postoperative complications and better spinal instability among these patients.A quality randomized controlled study on a much larger scale will be required to make the results more accurate.