Efficacy analysis of two surgical treatments for thoracic and lumbar intraspinal tumours

Song, Zhaojun; Zhang, Zhi; Ye, Yongjie; Zheng, Jian; Wang, Fandong

doi:10.1186/s12893-019-0602-9

Cited by 9 publications

(12 citation statements)

References 19 publications

(21 reference statements)

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“…17 Our design is based on a clinical surgical procedure called lamina replantation which replanted the lamina and spinal ligaments to stabilize the spine, prevent hypertrophic epidural fibrosis and have been reported achieving good clinical outcomes. [18][19][20] In the possible clinical setting, the surgical procedures of our design can be performed like lamina replantation. Briefly, after usual decompression with retaining the supraspinous and interspinous ligaments, the artificial lamina will be fixed by pedicle screws and the supraspinous and interspinous will be reconstructed by thick silk threads through the pilot hole designed pre-operation.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina

Liu

Yuan

et al. 2020

J Biomater Appl

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Background Laminectomy is a traditional method for treating lumbar diseases; however, the destruction of the posterior structures may cause postoperative symptoms. An individualized poly-ether-ether-ketone (PEEK) artificial lamina was designed to reconstruct the posterior structures after laminectomy. This study aimed to explore the biomechanical effects of reconstruction of the posterior structures with an individualized PEEK artificial lamina using validated finite element models. Objective To examine the biomechanical effects of individualized PEEK artificial lamina on postlaminectomy lumbar. Methods A finite element (FE) model of L3-5 was developed based on computed tomography images. Four surgical models (laminectomy, artificial lamina alone, ligament reconstruction, and osseointegration) were constructed, representing different stages of L4 artificial lamina implantation. The range of motion (ROM), intradiscal pressure (IDP), stresses in the annulus fibrosus at the surgical level and cephalad adjacent level, and stresses in the artificial lamina and screws were measured. Results The ROM, IDP, and stresses in the annulus fibrosus of the different artificial lamina models decreased compared to those of the laminectomy model at both surgical and adjacent levels for all motion patterns, most notably in the osseointegration model. In addition, the results of the stresses in the implants showed that the artificial lamina could enhance the lumbar isthmus and disperse the abnormally concentrated stresses after laminectomy. Conclusion The application of a PEEK artificial lamina has the potential to stabilize the postlaminectomy lumbar spine and prevent adjacent segment disease (ASD) and iatrogenic lumbar deformities, resulting in a reduction in the incidence of post-lumbar surgery syndrome.

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Section: Discussionmentioning

confidence: 99%

Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina

Liu

Yuan

et al. 2020

J Biomater Appl

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“…Zong et al [ 4 ] have reported that the total laminectomy and screw-rod internal fixation significantly reduced the incidence of spinal structural instability and kyphosis to some extent, comparing with the classical total laminectomy, in short-term follow-up. However, due to the loss of posterior bone structure, the scar tissue is still the risk of spinal cord compression after operation [ 1 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Laminoplasty has the obvious advantage of reducing the postoperative risks of classical total laminectomy by rebuilding the integrity of the posterior elements. Following the first report of lamina replantation by Raimondi in 1976 [ 7 ], a variety of laminoplasty, with a good satisfactory surgical results, has been used to treat patients with intraspinal tumors [ 5 , 6 , 8 – 10 ]. In addition, because the laminoplasty retains the relatively normal posterior structure, it can help avoid the epidural scar adhesion and contraction of the dura mater.…”

Section: Introductionmentioning

confidence: 99%

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Application of open-door laminoplasty with ARCH plate fixation in cervical intraspinal tumors

Wang

et al. 2021

BMC Surg

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Background The open-door laminoplasty is an effective procedure for the treatment of cervical spondylotic myelopathy. However, little information is available about the surgical results of open-door laminoplasty in the treatment of intraspinal tumors. In the present study, we aimed to investigate the clinical effect of open-door laminoplasty with ARCH plate fixation in the treatment of cervical intraspinal tumors. Methods This was a retrospective study. From January 2013 to May 2018, 38 patients (13 males and 25 females, the average age of 44 ± 17 years) with cervical intraspinal tumors underwent open-door laminoplasty with ARCH plate fixation in our hospital. The operation time, blood loss, pre- and postoperative visual analog scale (VAS), and Japanese Orthopedic Association (JOA) scores were determined. To determine the radiographic outcomes, cervical X-ray film and magnetic resonance imaging (MRI) were performed before and after the operation, and cervical X-ray sagittal film was used to measure Cobb angle. The clinical data before and after the operation were compared by t-test. Results A total of 38 patients underwent a successful operation and demonstrated primary healing. The average operation time was 113 ± 12 min. The average blood loss was 120 ± 19 mL. All patients were followed up for 26.1 ± 2.8 months, and the final follow-up time was more than 24 months. VAS scores were much better at 24 months after operation compared with those before the operation, which were decreased from 6.1 ± 1.1 to 1.4 ± 0.7 (t = 32.63, P < 0.01). The JOA score was improved from 9.9 ± 1.5 to 15.5 ± 0.6 (t = − 18.36, P < 0.01), and the mean JOA recovery rate was 79% ± 11% at 24 months after the operation. There was no significant difference in Cobb angle between pre-operation and 24 months after the operation, which was 9.8 ± 2.6 and 10.3 ± 3.1 respectively (t = − 0.61, P > 0.05). Neither spinal malalignment on the coronal plane nor displacement of the laminoplasty flap was observed on postoperative cervical X-ray and MRI examinations at the final follow-up. Conclusions Open-door laminoplasty with ARCH plate fixation was a safe and effective surgical approach for the treatment of cervical intraspinal tumors.

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“…At present, more and more surgeons are aware of the importance of reconstruction of spinal stability and reducing postoperative complications for postoperative recovery and quality of life of patients, and pay great attention to the maintenance of spinal stability during operation. Following the introduction of lamina replantation by Raimondi in 1976 5 , a series of laminoplasty has been developed for intraspinal tumor resection [6][7][8][9][10] . By preserving some or all of the posterior column elements, these techniques restore the stability and integrity of the posterior column structure of spine and significantly reduce the complications of classical total laminectomy.…”

Section: Introductionmentioning

confidence: 99%

Application of Laminoplasty Combined with ARCH Plate in the Treatment of Lumbar Intraspinal Tumors

Wang

Sun

et al. 2020

Orthopaedic Surgery

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Objective: To investigate the bone fusion and clinical effect of laminoplasty combined with ARCH plate fixation in the treatment of lumbar intraspinal tumors. Methods: This was a clinical study. From June 2017 to January 2019, 24 patients (seven males and 17 females, average age 40 ± 16 years) with lumbar intraspinal tumors underwent laminoplasty combined with ARCH plate fixation in our hospital. The bone fusion was evaluated by X-ray and computed tomography (CT) scans that were taken 15.2 ± 2.17 months postoperatively. Each segment showed a bone bridge on one side, which was classified as "segmental partial fusion." Each segment showed bilateral bone bridges, which were classified as "segmental complete fusion". When all segments of the patient showed bilateral bone bridging so that the replanted lamina and the host lamina became a unit on the CT scan, it was defined as "complete fusion". In addition, the operation time and blood loss were recorded. Fisher's exact test was used to analyze the potential influencing factors of bone healing, including age (≤40 years vs >40 years), gender, number of operated levels (single vs two). Paired t-test was used to analyze pre-and postoperative Oswestry Disability Index (ODI) scale and low back and leg pain visual analog scale (VAS). Results: A total of 33 segments of laminoplasty were successfully performed in 24 patients. The average operation time was 128 ± 18 minutes. The average blood loss was 110 ± 19 mL. All patients were followed up at least 12 months after operation (average, 15.2 ± 2.17 months). At the final follow-up, according to the definition of this study, the proportion of "segmental partial fusion" and "segmental complete fusion" were 30.3% (10/33) and 69.7% (23/33), respectively. And the proportion of patients with "complete fusion" was 70.8% (17/24). Age, gender, and number of operated levels were not associated with the fusion (P = 1.0, 0.37, and 0.06, respectively). ODI and VAS were much better at 1 month after operation and the final follow-up than those before the operation (P < 0.01). At 6 months after operation, the results of magnetic resonance imaging (MRI) showed that the supraspinous ligament was repaired, and there were no complications, such as spinal epidural scar recompression. Conclusions: Laminoplasty combined with ARCH plate was a better surgical method, and 70.8% of the patients showed complete bone fusion and there was no case of bilateral nonunion.

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Efficacy analysis of two surgical treatments for thoracic and lumbar intraspinal tumours

Cited by 9 publications

References 19 publications

Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina

Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina

Application of open-door laminoplasty with ARCH plate fixation in cervical intraspinal tumors

Application of Laminoplasty Combined with ARCH Plate in the Treatment of Lumbar Intraspinal Tumors

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