Flipped Reposition Laminoplasty for Excision of Intradural Extramedullary Tumors in the Thoracolumbar Spine: A Case Series of 14 Patients

Ramesh Kumar; Ijack Debbarma; Tankeshwar Boruah; Atul Sareen; Mohit Kumar Patralekh; Ashish Dagar; Shaffaf Abdul Kareem

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자료유형: 학술저널

저자정보: Ramesh Kumar (Vardhman Mahavir Medical College and Safdarjung Hospital) Ijack Debbarma (Vardhman Mahavir Medical College and Safdarjung Hospital) Tankeshwar Boruah (Vardhman Mahavir Medical College and Safdarjung Hospital) Atul Sareen (Vardhman Mahavir Medical College and Safdarjung Hospital) Mohit Kumar Patralekh (Vardhman Mahavir Medical College and Safdarjung Hospital) Ashish Dagar (Vardhman Mahavir Medical College and Safdarjung Hospital) Shaffaf Abdul Kareem (Vardhman Mahavir Medical College and Safdarjung Hospital)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.3

발행연도: 2020.1

수록면: 327 - 335 (9page)

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Study Design: A retrospective study was done to assess the outcome of the new technique of flipped reposition laminoplasty for excision of intradural extramedullary (IDEM) spinal tumors of the thoracolumbar region.Purpose: To describe flipped reposition laminoplasty technique and evaluate its outcomes. Overview of Literature: Laminectomy has been the conventional approach for the surgical excision of IDEM spinal tumors, but it has potential postoperative complications. Laminoplasty maintains the posterior arch of the spine and avoids complications seen in Laminectomy, such as instability, epidural scarring, and kyphotic deformity.Methods: Fourteen patients (nine females and five males) diagnosed with IDEM tumors of the thoracolumbar region operated between 2016 and 2018 were included in this study. Pathologically, five cases were schwannomas; four cases were meningiomas; two cases were ependymomas; and one case each was lymphoma, neurofibroma, and teratoma. All patients had their neurological deficits documented using the American Spinal Injury Association (ASIA) impairment scale. After completion of all preanesthetic formalities, the patients were operated upon by a single surgeon using the flipped reposition laminoplasty technique. Follow-up was done at 1, 3, 6, and 12 months post operation and yearly thereafter.Results: The mean age of the patients was 35.28 years (14–65 years), and the mean follow-up duration was 17 months (6–26 months). Two patients were assessed with ASIA grade A neurology, one patient improved to ASIA grade B, whereas the other did not improve. Two patients improved from ASIA grade B to ASIA grade D, and seven patients with ASIA grades C and D improved to ASIA grade E. Fusion at the osteotomy site was seen in 92.85% (13 out of 14) cases on one side within 6 months post operation. Fusion was seen in all the cases within 1 year post operation.Conclusions: Flipped reposition laminoplasty is an excellent technique providing adequate exposure and additional stability postoperatively.

#Laminectomy #Flipped reposition laminoplasty #Intradural extramedullary #American Spinal Injury Association impairment scale

참고문헌 (20)

참고문헌 신청

Arnautovic K / 2009 / Extramedullary intradural spinal tumors : a review of modern diagnostic and treatment options and a report of a series / Bosn J Basic Med Sci 9(Suppl 1):40~45

Aghayev K / 2011 / Adult intradural primary spinal cord tumors / J Natl Compr Canc Netw 9:434~447

Iida Y / 1990 / Postoperative lumbar spinal instability occurring or progressing secondary to laminectomy / Spine 15:1186~1189

Mayfield FH / 1976 / Complications of laminectomy / Clin Neurosurg 23:435~439

Yasuoka S / 1982 / Incidence of spinal column deformity after multilevel laminectomy in children and adults / J Neurosurg 57:441~445

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