APPLICATION OF POSTERIOR SPINAL CANAL RECONSTRUCTION IN SURGERY OF INTRASPINAL TUMOR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YEQing , HUANGWu , HEYunsong , NONGMingshan , LIANGTiansen , TANSuzhen , YANGXing

Department of Orthopedics, General Hospital of Guangxi Armed Police, Nanning Guangxi, 530003, P. R. China;

Corresponding author：

YEQing, Email: yqys2003@163.com

Keywords：

Intraspinal tumor; Laminoplasty; Posterior spinal canal reconstruction

DOI：

10.7507/1002-1892.20140212

Video：

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Objective To apply H-shaped allogeneic bone graft combined with spinous process replantation for posterior spinal canal reconstruction after removal of intraspinal tumors,and observe its effectiveness. Methods A total of 48 cases of thoracic and lumbar intraspinal tumors were recruited between February 2006 and May 2012,including 35 males and 13 females with a mean age of 29.5 years (range,17-48 years).The disease duration was 3-16 months (mean,10.5 months).Intraspinal tumors located at T_5,6 in 3 cases,at T₁₀ in 7 cases,at T₁₂,L₁ in 13 cases,at L₃ in 10 cases,and at L₄-S₁ in 15 cases.There were 18 cases of epidural meningioma,2 cases of epidural lipoma,3 cases of extramedullary neurological tumors,10 cases of extramedullary meningioma,6 cases of extramedullary schwannoma,6 cases of intramedullary ependymoma,and 3 cases of intramedullary astrocytoma.All patients underwent H-shaped allogeneic bone graft combined with spinous process replantation for posterior spinal canal reconstruction after removal of intraspinal tumor by posterior laminectomy.The Oswestry disability index (ODI) was used to assess postoperative symptom improvement,and the Frankel grade of spinal cord injury to evaluate the extent of nerve damage and recovery. Results After operation,8 cases had cerebrospinal fluid leakage,and 4 cases had yellowish exudate,and they were all cured after appropriate treatment; primary healing of wound was obtained in the other cases,without postoperative complication.Forty-eight patients were followed up 18-72 months (mean,38 months).CT showed all the graft bones healed and posterior spinal canal was well reconstructed without iatrogenic spinal stenosis formation.X-ray film showed no vertebral instability or spondylolisthesis,and no shifting of reconstructed vertebrae.MRI showed no recurrence except 1 case.The symptoms were improved significantly after operation; the ODI score at last follow-up (16.69±2.53) was significantly lower (t=0.89,P=0.00) than that at preoperation (47.83±7.25).The results of symptom improvement were excellent in 36 cases,good in 10 cases,fair in 1 case,and poor in 1 case; the excellent and good rate was 95.83%.At last follow-up,Frankel grade was improved significantly (Z=13.32,P=0.00) when compared with preoperative grade except 1 recurrent patient. Conclusion The application of the H-shaped allogeneic bone graft combined with spinous process replantation can well reconstruct the posterior spinal canal,and also can effectively avoid iatrogenic spinal stenosis,so it is worthy of promoting in the clinical treatment of intraspinal tumor surgery.

Citation： YEQing, HUANGWu, HEYunsong, NONGMingshan, LIANGTiansen, TANSuzhen, YANGXing. APPLICATION OF POSTERIOR SPINAL CANAL RECONSTRUCTION IN SURGERY OF INTRASPINAL TUMOR. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(8): 965-968. doi: 10.7507/1002-1892.20140212 Copy

1.	黄凯,谢大志,龙耀武,等.原发性椎管内肿瘤的诊断和手术治疗.吉林医学,2009,30(13):1315-1316.
2.	周强,陈德玉,史建刚,等.髓外硬膜下肿瘤的手术治疗与临床效果.中国矫形外科杂志,2009,17(7):485-487.
3.	谢京城,王振宇,马长城,等.660例椎管内肿瘤的手术治疗.中国微创外科杂志,2009,9(10):940-945.
4.	曹治东,李邦春.椎板切除术后硬膜外瘢痕粘连发生机制及预防研究进展.重庆医学,2012,11(21):2207-2209.
5.	Rabb CH.Failed back syndrome and epidural fibrosis.Spine J,2010,10(5):454-455.
6.	Abeloos L,De Witte O,Riquet R,et al.Long-term outcome of patients treated with spinal cord stimulation for therapeutically refractory failed back surgery syndrome:a retrospective study.Neurochirurgie,2011,57(3):114-119.
7.	Raffaeli W,Righetti D,Andruccioli J,et al.Periduroscopy:generalreview of clinical features and development of operative models.Acta Neurochir Suppl,2011,108:55-65.
8.	王智运,章凯,许俊杰,等.棘突椎板回植内固定术重建腰椎后柱结构的早期临床研究.中国修复重建外科杂志,2011,25(10):1276-1278.
9.	刘洪泉,孙印臣,王立忠,等.半椎板入路椎管内肿瘤显微切除术.中华神经外科杂志,2006,22(8):503-505.
10.	杨荣利,曲华毅,燕太强,等.肩胛下经胸入路切除及重建治疗上胸椎肿瘤.中华外科杂志,2008,46(19):1486-1489.
11.	Ostelo RW,Deyo RA,Stratford P,et al.Interpreting change Scores for pain and functional status in low back pain:towards international consensus regarding minimal important change.Spine (Phila Pa 1976),2008,33(1):90-94.
12.	Banczerowski P,Vajda J,Veres R.Removal of intraspinal space-occupying lesions through unilateral partial approach,the "hemi-semi lam inectomy".Ideggyogy Sz,2008,61(3-4):114-122.
13.	Kato Y,Kaneko K,Kataoka H,et al.Cervical hemilaminoplasty:technical note.J Spinal Disord Tech,2007,20(4):296-301.
14.	唐欣,杨述华,余从年,等.同种异体冻干辐照骨板在椎管重建过程中的应用.山东医药,2006,46(23):8-10.
15.	蒋电明,权正学,黄伟,等.纳米羟基磷灰石/聚酰胺66复合生物活性人工椎板的初步临床应用.中国修复重建外科杂志,2007,21(5):441-444.
16.	Lv C,Zhou Z,Song Y,et al.Novel biodegradable lamina for lamina repair and reconstruction.Spine J,2013,13(12):1912-1920.
17.	Fritsh EW,Heisiel J,Roupp S.The failed back surgery syndrome:reasons,a report of 182 operative treatments.Spine (Phila Pa 1976),1996,21(5):626-633.
18.	Le Corre M,Lonjon G,Khouri K,et al.Giant spinal schwannoma:complete excision and one-step posterior spinal reconstruction.Spine J,2012,12(11):1075-1076.
19.	徐辉,肖嵩华,刘郑生,等.胸腰椎转移瘤的外科治疗策略和效果分析.中国骨伤,2014,27(1):25-28.

1. 黄凯,谢大志,龙耀武,等.原发性椎管内肿瘤的诊断和手术治疗.吉林医学,2009,30(13):1315-1316.
2. 周强,陈德玉,史建刚,等.髓外硬膜下肿瘤的手术治疗与临床效果.中国矫形外科杂志,2009,17(7):485-487.
3. 谢京城,王振宇,马长城,等.660例椎管内肿瘤的手术治疗.中国微创外科杂志,2009,9(10):940-945.
4. 曹治东,李邦春.椎板切除术后硬膜外瘢痕粘连发生机制及预防研究进展.重庆医学,2012,11(21):2207-2209.
5. Rabb CH.Failed back syndrome and epidural fibrosis.Spine J,2010,10(5):454-455.
6. Abeloos L,De Witte O,Riquet R,et al.Long-term outcome of patients treated with spinal cord stimulation for therapeutically refractory failed back surgery syndrome:a retrospective study.Neurochirurgie,2011,57(3):114-119.
7. Raffaeli W,Righetti D,Andruccioli J,et al.Periduroscopy:generalreview of clinical features and development of operative models.Acta Neurochir Suppl,2011,108:55-65.
8. 王智运,章凯,许俊杰,等.棘突椎板回植内固定术重建腰椎后柱结构的早期临床研究.中国修复重建外科杂志,2011,25(10):1276-1278.
9. 刘洪泉,孙印臣,王立忠,等.半椎板入路椎管内肿瘤显微切除术.中华神经外科杂志,2006,22(8):503-505.
10. 杨荣利,曲华毅,燕太强,等.肩胛下经胸入路切除及重建治疗上胸椎肿瘤.中华外科杂志,2008,46(19):1486-1489.
11. Ostelo RW,Deyo RA,Stratford P,et al.Interpreting change Scores for pain and functional status in low back pain:towards international consensus regarding minimal important change.Spine (Phila Pa 1976),2008,33(1):90-94.
12. Banczerowski P,Vajda J,Veres R.Removal of intraspinal space-occupying lesions through unilateral partial approach,the "hemi-semi lam inectomy".Ideggyogy Sz,2008,61(3-4):114-122.
13. Kato Y,Kaneko K,Kataoka H,et al.Cervical hemilaminoplasty:technical note.J Spinal Disord Tech,2007,20(4):296-301.
14. 唐欣,杨述华,余从年,等.同种异体冻干辐照骨板在椎管重建过程中的应用.山东医药,2006,46(23):8-10.
15. 蒋电明,权正学,黄伟,等.纳米羟基磷灰石/聚酰胺66复合生物活性人工椎板的初步临床应用.中国修复重建外科杂志,2007,21(5):441-444.
16. Lv C,Zhou Z,Song Y,et al.Novel biodegradable lamina for lamina repair and reconstruction.Spine J,2013,13(12):1912-1920.
17. Fritsh EW,Heisiel J,Roupp S.The failed back surgery syndrome:reasons,a report of 182 operative treatments.Spine (Phila Pa 1976),1996,21(5):626-633.
18. Le Corre M,Lonjon G,Khouri K,et al.Giant spinal schwannoma:complete excision and one-step posterior spinal reconstruction.Spine J,2012,12(11):1075-1076.
19. 徐辉,肖嵩华,刘郑生,等.胸腰椎转移瘤的外科治疗策略和效果分析.中国骨伤,2014,27(1):25-28.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF POSTERIOR SPINAL CANAL RECONSTRUCTION IN SURGERY OF INTRASPINAL TUMOR

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