Chen Dingbang, Song Jinhan, Zhang Luosheng, Gao Xin, Huang Quan, Yang Xinghai
Orthopaedic Oncology Center, Department of Orthopedics, Changzheng Hospital, Naval Military Medical University, Shanghai, China.
Orthop Surg. 2025 Jan;17(1):202-211. doi: 10.1111/os.14288. Epub 2024 Nov 4.
Lamina-implantation is gradually becoming the main surgical method for the treatment of intraspinal tumors. Traditional titanium (Ti) internal fixation not only produces artifacts, which affects the observation of tumors and dural sac closure, but also faces the problem of secondary surgical removal. In this study, absorbable material were used in lamina replantation for the first time and was evaluated for its efficacy and safety.
We retrospectively enrolled patients who underwent short-segment lamina replantation for intraspinal tumors in our center from February 2020 to November 2022. After condition matching of the number of fixation segment and fixation position, the baseline information, complications, neurological function, quality of life, spinal mobility and bone healing rate of the absorbable group and the Ti group were compared. Fisher exact, Chi-square, or rank sum test were used for categorical variables, and t-test was used for continuous variables to distinguish differences between groups.
Cerebrospinal fluid leak was the most common complication, with no difference between the two groups (12.9% vs. 19.4%, p = 0.366). The bone healing rates of the two groups at 3 months after surgery were 77.4% and 87.1%, respectively, and there was no significant difference (p = 0.508). At 1 year after surgery, the resorbable group showedlower levels of anxiety/depression (1.20 ± 0.41 vs. 1.61 ± 0.61, p = 0.050), however, it did not affect the overall quality of life of the patients at 1 year.
Both titanium and absorbable internal fixation have shown good clinical results in the treatment of intraspinal tumors by laminareplantation. Regardless of cost, absorbable screws and plates are also suitable options for patients undergoing lamina replantation, because it has no stress shielding effect and does not require secondary removal. In addition, there are no artifacts in the image, which is more conducive to observing the recurrence of the tumor and the closure of the dural sac.
椎板再植术正逐渐成为治疗椎管内肿瘤的主要手术方法。传统的钛（Ti）内固定不仅会产生伪影，影响肿瘤观察和硬脊膜囊闭合，还面临二次手术取出的问题。本研究首次将可吸收材料用于椎板再植，并对其疗效和安全性进行评估。
我们回顾性纳入了2020年2月至2022年11月在本中心接受短节段椎板再植治疗椎管内肿瘤的患者。在固定节段数量和固定位置进行条件匹配后，比较可吸收组和钛组的基线信息、并发症、神经功能、生活质量、脊柱活动度和骨愈合率。分类变量采用Fisher确切概率法、卡方检验或秩和检验，连续变量采用t检验来区分组间差异。
脑脊液漏是最常见的并发症，两组之间无差异（12.9%对19.4%，p = 0.366）。两组术后3个月的骨愈合率分别为77.4%和87.1%，无显著差异（p = 0.508）。术后1年，可吸收组焦虑/抑郁水平较低（1.20±0.41对1.61±0.61，p = 0.050），然而，这并未影响患者术后1年的整体生活质量。
钛和可吸收内固定在椎板再植治疗椎管内肿瘤方面均显示出良好的临床效果。不考虑成本因素，可吸收螺钉和钢板对于接受椎板再植的患者也是合适的选择，因为它没有应力遮挡效应，也不需要二次取出。此外，图像中没有伪影，更有利于观察肿瘤复发和硬脊膜囊闭合情况。
