Spinal Instability Following Laminectomy Versus Laminoplasty For Resection Of Spinal Tumors:Analysis Of210Patients

ObjectiveThrough comparing the difference between laminectomy and laminoplasty for resection surgery of spinal tumors, the recovery of neural function after operation, postoperative spinal stability provides the basis options for operation method choice.MethodRetrospectively studied210cases of spinal tumor parallel clinical data in surgical treatment patients in our hospital from2009to2011. Compared with the tumor type and location, clinical features, neurological function, postoperative complications and neurological function recovery after operation and postoperative spinal stability evaluation.ResultsIn210patients,98cases of male,112cases of female;166cases of laminectomy (162totally removal,4partial removals),44cases of laminoplasty (all totally removal).Average operation time of laminectomy group was (150.71±30.70) minutes, average operation time of laminoplasty group was (147.25±24.80) minutes, two groups of comparison (P=0.109); the mean loss of blood of laminectomy group was (131.93±36.41) ml, the mean loss of blood of laminoplasty group was (115.45±22.97) ml, two groups of comparison (P=0.425); length of stay of laminectomy group was (18.89±6.36) days, length of stay days of laminoplasty group was (15.523±3.629) days, length of stay days of laminoplasty group is shorter than laminectomy group (P=0.036); there was no significant difference of postoperative complications; pre-operation of laminectomy for IJOA score was(17.33±1.96), pre-operation of laminoplasty for IJOA score was (18.39±0.97), two groups of comparison (P=0.809); post-operation of laminectomy for IJOA score was (19.24±1.08), post-operation of laminoplasty for IJOA score was (19.57±0.50), Two groups of comparison (P=0.195);both of them improved IJOA score. Postoperative cervical instability of laminectomy group was35.7%, laminoplasty group was33.3%, comparing the two groups (P=0.876), Postoperative thoracolumbar instability of laminectomy group was16.6%, laminoplasty group was13.8,comparing the two groups (P=0.702), the incidence of spinal instability of laminectomy group was19.9%, laminoplasty group was20.5%, comparing the two groups (P=0.932).Tumor segmental resection level>=3, the incidence of spinal instability of laminectomy was33.3%, compared with<3segments have significant difference (P=0.001), the incidence of spinal instability of laminoplasty was22.2%, compared with<3section there was no significant difference (P=0.250).ConclusionLaminectomy and laminoplasty for resection of spinal tumor can both improve the spinal neurological functions,Laminoplasty has advantage of shorten the time of hospitalization,but for operation time、 blood losing and postoperative complications, laminoplasty has no obvious advantage. There are no difference between Laminectomy and laminoplasty in postoperative spinal instability, but if segmental resection level>3,laminoplasty may protect spinal stability more effectively than laminectomy.