Effects of laminoplasty and spinal fusion on adult spinal canal benign tumors

XU Ming; ZHENG Kai; YU Xiu-chun

doi:10.3969/j.issn.2095-252X.2018.05.003

Abstract：Objective To evaluate the clinical effects of laminoplasty and spinal fusion on adult spinal canal benign tumors by a retrospective analysis. Methods From March 2009 to November 2015, 67 adult patients with intraspinal benign tumors were selected. There were 32 cases in the laminoplasty group and 35 cases in the spinal fusion group. All the patients were followed up for more than 2 years. Operation time, intraoperative blood loss and hospitalization costs were recorded. Efficacy evaluation was performed using Modified Mccormick scale ( MMS ), visual analogue scale ( VAS ) and JOA bladder sphincter function score. Spinal stability was assessed by White and Panjabi's diagnostic criteria. An independent sample t test or Mann-Whitney U test was used to compare the mean between the 2 groups. Results Laminoplasty group: the average operation time was 131 min; the average amount of bleeding was 140 ml; the average hospitalization cost was 35094 yuan; All three were significantly different from that of the fusion group ( 167 min, 249 ml and 41693 yuan ) ( ttime= -5.183, P = 0.000; Zbleeding= -19.88, P = 0.000;Zhospitalization=-2.015,P=0.044).There were no significant differences in functional scores of MMS,VAS and JOA bladder sphincter between the 2 groups ( P > 0.05 ). At the last follow-up, 4 cases of vertebral lamina were not healed in the laminoplasty group, and 3 cases of adjacent segment degeneration were found in the fusion group. There was no spinal instability in both groups. No tumor recurrence or death. Conclusions Laminoplasty and spinal fusion, in the treatment of benign tumors in adult spinal canal, can prevent postoperative spinal instability and have similar clinical effects. Laminoplasty has the advantages of short operation time, less blood loss, lower hospitalization costs.