Laminectomy vs Fusion for Intradural Extramedullary Tumors.

BACKGROUND

Laminectomy (LA) and LA with fusion (LAF) have been demonstrated as surgical techniques that treat intradural extramedullary tumors (IDEMTs). The purpose of the present study was to compare the rate of 30-day complications following LA vs LAF for IDEMTs.

METHODS

Patients undergoing LA for IDEMTs from 2012 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients undergoing LA for IDEMTs were substratified into 2 cohorts: those who received LAF and those who did not. In this analysis, preoperative patient characteristics and demographic variables were assessed. 30-day wound, sepsis, cardiac, pulmonary, renal, and thromboembolic complications, as well as mortality, postoperative transfusions, extended length of stay, and reoperation, were assessed. Bivariate analyses, including and tests, and multivariable logistical regression were performed.

RESULTS

Of 2027 total patients undergoing LA for IDEMTs, 181 (9%) also had fusion. There were 72/373 (19%) LAF in the cervical region, 67/801 (8%) LAF in the thoracic region, and 42/776 (5%) LAF in the lumbar region. Following adjustment, patients who received LAF were more likely to have increased length of stay (OR 2.73, < 0.001) and increased rate of postoperative transfusion (OR 3.15, < 0.001). Patients undergoing LA in the cervical spine for IDEMTs tended to receive additional fusion ( < 0.001).

CONCLUSIONS

Increased length of stay and rate of postoperative transfusion were associated with LAF for IDEMTs. LA in the cervical spine for IDEMTs was associated with additional fusion.