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脊髓肿瘤椎板成形术与椎板切除术治疗中脊柱稳定性及术后并发症的比较

Comparison of spinal instability and postoperative complications between laminoplasty and laminectomy surgery for spinal cord tumors.

作者信息

Yoo Hyun Jin, Noh Sung Hyun, Kim Sang Hyun, Cho Pyung Goo

机构信息

Department of Neurosurgery, Ajou University College of Medicine, Suwon-si, Republic of Korea.

出版信息

Medicine (Baltimore). 2025 Apr 18;104(16):e42236. doi: 10.1097/MD.0000000000042236.

Abstract

This study aimed to compare kyphotic changes and postoperative complications between laminectomy and laminoplasty for spinal cord tumors. We retrospectively included 110 patients who underwent spinal cord tumor resection at the Ajou University Medical Center, Korea, between January 1994 and March 2022 to compare the complications and postoperative kyphotic changes between laminectomy and laminoplasty. A total of 59 and 51 patients underwent laminectomy and laminoplasty, respectively. The groups had similar demographic characteristics. Tumor locations were classified as cervical, thoracic, and lumbar lesions and were compared. We measured preoperative and postoperative radiological parameters and identified postoperative complications. In the laminoplasty group, we studied 7, 19, and 25 cases at the cervical, thoracic, and lumbar levels, respectively. In the laminectomy group, we studied 13, 31, and 15 cases at the cervical, thoracic, and lumbar levels, respectively. At the cervical level, lordosis from C2 to C7 was 8.66 ± 5.06° before and 15.86 ± 12.54° after surgery and was 10.5 ± 6.82° before and 9.16 ± 6.5° after surgery in the laminoplasty and laminectomy groups, respectively. At the thoracic level, kyphosis from T5 to T12 was 27.89 ± 9.93° before and 23.18 ± 9.10° after surgery and was 29.94 ± 9.56° before and 28.41 ± 12.58° after surgery in the laminoplasty and laminectomy groups, respectively. At the lumbar level, lordosis from L1 to S1 was 40.86 ± 14.12° before and 42.62 ± 10.39° after surgery and was 43.65 ± 8.47° before and 37.44 ± 13.32° after surgery in the laminoplasty and laminectomy groups, respectively. Postoperative complications, such as cerebrospinal fluid leakage, infection, and hematoma, were more frequent in the laminectomy group than in the laminoplasty group. Laminoplasty rather than laminectomy for spinal cord tumor surgery can reduce postoperative complications and prevent kyphosis.

摘要

本研究旨在比较脊髓肿瘤椎板切除术和椎板成形术之间的后凸变化及术后并发症。我们回顾性纳入了1994年1月至2022年3月期间在韩国庆熙大学医学中心接受脊髓肿瘤切除术的110例患者,以比较椎板切除术和椎板成形术之间的并发症及术后后凸变化。分别有59例和51例患者接受了椎板切除术和椎板成形术。两组患者的人口统计学特征相似。肿瘤位置分为颈椎、胸椎和腰椎病变并进行比较。我们测量了术前和术后的影像学参数并确定了术后并发症。在椎板成形术组中,颈椎、胸椎和腰椎水平分别研究了7例、19例和25例。在椎板切除术组中,颈椎、胸椎和腰椎水平分别研究了13例、31例和15例。在颈椎水平,椎板成形术组和椎板切除术组从C2至C7的前凸角度术前分别为8.66±5.06°和术后为15.86±12.54°,术前分别为10.5±6.82°和术后为9.16±6.5°。在胸椎水平,椎板成形术组和椎板切除术组从T5至T12的后凸角度术前分别为27.89±9.93°和术后为23.18±9.10°,术前分别为29.94±9.56°和术后为28.41±12.58°。在腰椎水平,椎板成形术组和椎板切除术组从L1至S1的前凸角度术前分别为40.86±14.12°和术后为42.62±10.39°,术前分别为43.65±8.47°和术后为37.44±13.32°。椎板切除术组术后脑脊液漏、感染和血肿等并发症比椎板成形术组更常见。脊髓肿瘤手术采用椎板成形术而非椎板切除术可减少术后并发症并预防后凸畸形。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e738/12014118/b151e25d94fc/medi-104-e42236-g001.jpg

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