Clinical Contrast Study Of Hemilaminectomy And Total Laminectomy Microsurgery Of Resecting Intramedullary Tumors

Objective To grasp the anatomical level and exposure scope of removing intramedullarytumors through posterior midline approach by the anatomy of spinal region.Contrastively to analyze the two operation methods of intramedullary tumors excisionthrough hemilaminectomy and total laminectomy approach to explore the advantages anddisadvantages, clinical indications, clinical curative effect and the influence on the spinalstabilization of hemilaminectomy excision, and to summarize the surgical skill andexperience.Methods Adult’s upper body samples from13cases were obtained to observe theanatomical level of spinal posterior midline approach, spinal canal and its adjacentstructures, to measure the vertebral plate data of vertebral bodies, and to masteranatomical features of the spine area. Thus, offering a scientific basis for clinical surgicalapproach.32patients with spinal cord tumors that surgically treated throughhemilaminectomy from February2012to January2014and the clinical data of38patients with spinal cord tumors removed through total laminectomy were included inthe study. Two groups of patients with gender, age, diseasedparts, tumor type and theonset time have been analyzed. The operation time, blood loss, getting out of bed time,postoperative hospital stay, resectability of the tumor were compared between two groups.McCorick clinical classification standard was adopted to compare the cure situation andpostoperative complications. All the surgical cases were followed up with the evaluationof spinal stability in patients. And all dates were analyzed statistically by SPSS software.Results Statistical analysis on the basic information (gender, age, tumor location, tumortype and disease time) of patients from two groups has been done and the difference wasnot statistically significant (P＞0.05). Thus, the basic situations of patients from thetwo groups were comparable. Comparing operation time, hospital stay, peri-operationbleeding and postoperative activity time of the two groups by T test was statisticallysignificant (P＜0.05). Compared resection rate of patients from the two groups byChi-square test, the difference was not statistically significant (P＞0.05). Thenevaluated prognosis of the two groups of patients and compared them by Chi-square test,the difference has no statistical significance (P＞0.05). Patients with hemilaminectomy have no complication at the time of hospitalization and have no deformity of spineaccording to the random visits, while there were4cases of complications at the time ofhospitalization and4cases of spinal deformity within patients with laminectomy. Thetwo groups of patients were compared by Chi-square test, and the differences arestatistically significant (P＜0.05). Compared hemilaminectomy and laminectomy forthe removal of intraspinal tumors, there’s no distinct difference in the extent of symptomimprovement and the rate of tumor resection, but hemilaminectomy is clearly superior tolaminectomy in operation time, peri-operation bleeding, postoperative activity time,postoperative complications, long-term spinal stability and other aspects.Conclusion Hemilaminectomy for the removal of intraspinal tumors has theadvantages of minimal morbidity, getting out of bed early, which has a significantclinical effect in short-term and long-term, and is beneficial to the stability of spine.Although it has the disadvantages of exposure limitation, the space ofintralesional resection under the microscope is enough and can do the majorityhemilaminectomy for the removal of intraspinal tumors.