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首页> 外文期刊>Neurosurgical focus >Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal cord tumors in pediatric patients
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Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal cord tumors in pediatric patients

机译：椎板切除或椎板成形术后脊柱畸形的器械融合术在小儿患者的髓内脊髓肿瘤切除术中的应用

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OBJECTIVE Spinal deformity has become a well-recognized complication of intramedullary spinal cord tumor (IMSCT) resection. In particular, laminectomy can result in biomechanical instability caused by loss of the posterior tension band. Therefore, laminoplasty has been proposed as an alternative to laminectomy. Here, the authors describe the largest current series of pediatric patients who have undergone laminoplasty for IMSCT resection and investigate the need for surgical fusion after both laminectomy and laminoplasty. METHODS The medical records of pediatric patients who underwent resection of an IMSCT at a single institution between November 2003 and May 2014 were reviewed retrospectively. Demographic, clinical, radiological, surgical, histopathological, and follow-up data were collected. RESULTS Sixty-six consecutive patients underwent resection of an IMSCT during the study period. Forty-three (65%) patients were male. The patients had a median age of 12.9 years (interquartile range [IQR] 7.2–16.5 years) at the time of surgery. Patients typically presented with a tumor that involved the cervical and/or thoracic spine. Nineteen (29%) patients underwent laminectomy, and 47 (71%) patients underwent laminoplasty. Patients in each cohort had a similar rate of postoperative deformity. Overall, 10 (15%) patients required instrumented spinal fusion for spinal deformity. Four patients required revision of the primary fusion. CONCLUSIONS These findings show that among pediatric patients with an IMSCT, postoperative surgical fusion rates remain high, even after laminoplasty. Known risk factors, such as the age of the patient, location of the tumor, and the number of involved levels, might play a larger role than replacement of the laminae in determining the rate of surgical fusion after IMSCT resection.
机译：目的脊柱畸形已成为公认的髓内脊髓肿瘤切除术（IMSCT）并发症。特别地，椎板切除术可导致由后张力带的丧失引起的生物力学不稳定性。因此，已经提出了椎板成形术作为椎板切除术的替代方案。在这里，作者描述了目前最大的一系列接受了IMSCT切除的椎板成形术的儿科患者，并研究了椎板切除术和椎板成形术后是否需要手术融合。方法回顾性分析2003年11月至2014年5月在同一机构接受IMSCT切除的小儿患者的病历。收集了人口统计学，临床，放射学，外科，组织病理学和随访数据。结果在研究期间，连续66例患者接受了IMSCT切除术。四十三（65％）例患者为男性。手术时患者的中位年龄为12.9岁（四分位间距[IQR] 7.2-16.5岁）。患者通常表现出涉及颈椎和/或胸椎的肿瘤。 19例（29％）患者接受了椎板切除术，47例（71％）患者进行了椎板成形术。每个队列中的患者术后畸形率相似。总体而言，有10名（15％）患者需要使用仪器进行脊柱融合术治疗脊柱畸形。四名患者需要进行初次融合术的修订。结论这些发现表明，在有IMSCT的小儿患者中，即使在椎板成形术之后，术后手术融合率仍然很高。在确定IMSCT切除后的手术融合率方面，已知的危险因素（例如患者的年龄，肿瘤的位置以及受累程度的数量）可能比更换薄片更重要。

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