Open AccessApplication of Laminoplasty Combined with ARCH Plate in the Treatment of Lumbar Intraspinal Tumors
Author(s) -
Wang ZhiChao,
Li ShuZhong,
Sun YuanLiang,
Yin ChuQiang,
Wang YueLei,
Wang Jie,
Liu ChenJing,
Cao ZhenLu,
Wang Ting
Publication year - 2020
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12758
Subject(s) - medicine , laminoplasty , surgery , oswestry disability index , lumbar , visual analogue scale , fixation (population genetics) , low back pain , laminectomy , spinal cord , population , alternative medicine , environmental health , pathology , psychiatry
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.