Clinical application of laminoplasty to surgery for multisegmental intraspinal lesions

ZHOU Quan; XIAO Shao-wen; TAN Yuan-fu; ZHANG Chao-yuan; LIAO Xing-sheng; LU Xing; ZONG Shao-hui

doi:10.13798/j.issn.1009-153X.2015.02.002

Abstract：Objective To explore the technique and advantages of laminoplasty and its effect on multisegmental spinal lesions. Methods The clinical data of 56 patients with multisegmental intraspinal lesions, who received laminoplasty after the resection of the intraspinal lesions from April, 2009 to April, 2013, were retrospectively analyzed. The lesions invaded 6 or 7 segments of the spinal cords in 14 patients and 3~5 segments in 42 patients. Both the sides of the laminae were opened by the grinding knife and the complex of spinous process and vertebral plate was formed and taken out. The complex was reduced and fixed by titanium plate, and the laminoplasty was completed after the resection of intraspinal lesions. Results Of 56 patients with multisegmental intraspinal lesions, 52 (92.9%) received total resection of the lesions and 4 (7.1%) subtotal. No patients died. There was not damage to the dura mater spinalis and spinal nerve root in all the patients. The postoperative MRI and CT showed that the complex of spinous process and vertebral plate was well reduced and the vertebral canal stenosis did not occur in all the patients. The following-up from 1 to 5 years showed that there not were the secondary stenosis of vertebral canal, kyphosis or instability of the spinal column in all the patients. Conclusions The above-mentioned surgical method can provide adequate exposure for the resection of the multisegmental intraspinal lesions. The bony structure of the spinal canal can be anatomically reconstructed and the stability of spinal column after the operation can be maintained, and the iatrogenic stenosis of the vertebral canal after the operation can be prevented by the laminoplasty in the patients with multisegmental intraspinal lesions, in whom the laminoplasty was safe and may improve curative effect of the surgery on the multisegmental intraspinal lesions.