Anatomic and functional reconstruction of the spinal posterior column after resection of intraspinal neoplasms / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the operative outcomes of anatomic and functional reconstruction of the spinal posterior column after resection of intraspinal neoplasms.Methods From January 2010 through October 2014,we treated 32 patients with intraspinal neoplasm in the spine.They were 18 men and 14 women,13 to 62 years of age (average,38 years).The neoplasm was detected in the cervical spine in 10 cases,in the thoracic spine in 14 and in the lumbar spine in 8.All cases received expansive open door laminoplasty via the posterior approach for resection of the intraspinal neoplasm,followed by replantation and titanium plate fixation for anatomic and functional reconstruction of the spinal posterior column.The neural functional recovery,spinal motion and sagittal diameter of the spinal canal before and after operation,spinal stability and graft fusion were observed.Results The patients were followed up for 3 to 23 months (average,13 months).All the intraspinal neoplasms were completely resected.The Frankel grading of neural functional recovery was improved differently in all the cases.By the final follow-ups,the spinal motion was normal in all the cases,without any significant limitation.Graft fusion and rigid internal fixation were achieved in all the cases.Short-term follow-ups revealed no signs of spondylolisthesis or spinal instability.At the final follow-ups,the 3-D CT reconstruction showed no significant shortening in the sagittal diameter of the same spinal canal before and after operation (P ＞0.05).Conclusions For intraspinal neoplasm in the spine,the whole vertebral lamina is opened or removed via the posterior approach to resect the neoplasm,followed by reduction of the vertebral lamina and mini titanium plate fixation to reconstruct the anatomy and function of the original spine.This is an ideal way to treat intraspinal neoplasms in the spine.