Application of total laminectomy with preserved spinous process and replantation for the primary tumor of the thoracolumbar spinal canal
Wu Yuxian1, Ji Yuqing1, Li Jianmin1, Li Yuchun1, Wang Guanghui1, Jiang Wen1, Yang Qiang2, Li Zhenfeng2
1Department of Orthopaedic Oncology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266071, China; 2Department of Orthopaedic Oncology, Qilu Hospital of Shandong University, Jinan 250012, China
Abstract：Objective To investigate the clinical effect of total laminectomy with preserved spinous process and replantation for the treatment of primary tumor of the thoracolumbar spinal canal.Methods A retrospective analysis. From July 2013 to July 2017, 92 patients with primary tumor of thoracolumbar spinal canal were included, with 48 male, 44 female; aged 41-79 years old, average (53.9±10.2) years old. All patients treated with total laminectomy tumor resection, osteotomy replantation and pedicle internal fixation. According to whether or not to preserve spinous process, 92 patients were divided into two group, preserved spinous process group(34 patients) and without preserved spinous process group (58 patients). The operative time, bleeding volume, recurrence of tumors, fusion of bone grafts, postoperative function and complications were observed. Visual analogue scale (VAS) in thoracolumbar spine and Japanese Orthopaedic Association(JOA) nerve function score were compared between the two groups.Results All patients underwent successful operation, and the lesions were completely removed. The time of operation in with preserved spinous process group was (188±17) min, which was no significantly different from that in without preserved spinous process group (190±16)min (t=-0.564, P＞0.05). The amount of bleeding in with preserved spinous process group was (386±50) mL, and the difference was no statistically significant (t=0.604, P＞0.05) with without preserved spinous process group (380±44) mL. After 3 months of the with preserved spinous process group VAS preoperative average score was (2.07±0.28) points, and without preserved spinous process group was (2.45±0.30) there was significant difference (t=-5.881, P＜0.01). In the with preserved spinous process group, JOA average score was (15.6±1.8)points, and without preserved spinous process group was (13.8±2.0) points there was significant difference (t=4.374, P＜0.01). In the with preserved spinous process group, bone fusion time was (4.0±0.6) months, and without preserved spinous process group was (4.4±0.7) months there was significant difference (t=-2.646, P＜0.01).Conclusions Total laminectomy with preserved spinous process and replantation for the treatment of primary tumor of the thoracolumbar spinal canal is benefical to the restoration of the anatomical structure of the spine, functional rehabilitation and bone fusion.
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Wu Yuxian, Ji Yuqing, Li Jianmin, Li Yuchun, Wang Guanghui, Jiang Wen, Yang Qiang, Li Zhenfeng. Application of total laminectomy with preserved spinous process and replantation for the primary tumor of the thoracolumbar spinal canal. Chinese Journal of Anatomy and Clinics, 2019, 24(3): 227-231.
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2019, Vol. 24 
