Comparative Analysis The Spinal Stability Of Hemilaminectomy And Total Laminectomy Approach For Cervical Intraspinal Tumors

Background and ObjectiveTo gasping the anatomic structure of cervical spine and the anatomical layers of the intraspinal cord tumors operation,and then provide guidance to the clinical surgery.Comparative analysis the spinal stability of hemilaminectomy and total laminectomy approach for dumbbell and non-dumbbell cervical spinal tumors,and provide advices on cervical spinal tumors operations.MethodsTaking 10 specimens of complete cervical vertebrae,measure the width and height of lamina,the diameter and radius of the spinal canal.Taking a pair of muscle specimens containing the complete items,and observe the anatomic and adjacent structures of the posterior cervical approach.Retrospective analysis the 96 adult patients clinical data in Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University from March2013 to September 2016.The semi laminectomy approach was 34 cases,and total laminectomy approach was 41 cases,In the total 75 non-dumbbell cervical spinal tumors,the semi laminectomy and total laminectomy approach were 34 and 41 cases respectively,and in the total 21 dumbbell cervical spinal tumors there were 8 and 13 cases.All patients followed up over 3 months.Compare the operation time,bleeding volume,postoperative bed time,hospitalization time and tumor resection rate,postoperative effect,cervical instability rate in different groups.McCorick classification was used to evaluate the effect of the operation,and the stability of the cervical spine was observed according to the postoperative MRI.All the data were analyzed by SPSS 18.0 statistical software.Results1.The width of the cervical lamina was about 16.1±0.9 mm,and the height was12.3±1.3mm,the diameter of the spinal canal was15.8±12.mm,and the radius was21.7±1.5mm.2.There was no significant difference between the two surgical approach in the dumbbell and non-dumbbell cervical spinal tumors groups in operation time,blood loss,tumor resection rate,and the short-term and long-term effects(p>0.05).The average postoperative activity out of bed days of hemilaminectomy approach in the dumbbell and non-dumbbell groups was 5.7±1.5d?5.7±0.8d,respectively;and the total laminectomy approach in the tow groups was 12.4±1.2d,13.1±1.6d,respectively.The differences between the both two groups was statistically significant(P<0.05).The average length of hospital stay for the semi laminectomy approach in the dumbbell and non-dumbbell groups was 12.5±1.6d,11.4±1.2d,respectively;and for the total laminectomy approach was 18.8±1.8d,17.0±0.9d,respectively.The difference between the both two groups was statistically significant.In the dumbbell groups,there was 0 case of cervical instability occurred in the patients who underwent semi laminectomy,while there were 7 cases occurred in total laminectomy approach group.The difference between the two groups was statistically significant.In the non-dumbbell groups,there was 0 case of cervical instability occurred in the patients who underwent semi laminectomy,while there were 5 cases occurred in total laminectomy approach group.The difference between the two groups was statistically significant.5 patients occurred cervical instability in the non-dumbbell group,who underwent total laminectomy approach,and the number who underwent semilaminectomy was 7.The difference between the two groups was statistically significant.There are the same effects with the total laminectomy approach in thecontrol and elimination of symptoms in patients with long term remission,but to shorten the patient bed and hospitalization time,reduce the postoperative incidence of cervical spine instability,semilaminectomy approach has obvious advantages.ConclusionsSemilaminectomy for the treatment of cervical spinal canal tumors has the superiorities of less trauma,faster recovery,less postoperative complications and other obvious advantages.At the same time,it has a good protective effect on postoperative cervical stability,is a safer and more reliable surgical method.The cervical spine is wide enough and provides adequate surgical space for microsurgery operation.