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Objective To compare the clinical results of the unilateral hemilaminectomy approach and the total laminectomy ap-proach in the treatment of subdural extramedullary tumors.Methods One hundred cases with subdural extramedullary tumors from Sep-tember 2010 to September 2013 in the General Hospital of Ningxia Med.Univ.underwent surgery intervention were prospective analyzed. Among them,50 cases( the observation group) received tumor resection by the unilateral hemilaminectomy approach,and another 50 cases ( the control group) received the treatment by the total laminectomy approach.All received electrophysiological monitoring in the opera-tion.Operation time,intraoperative bleeding,postoperative hospitalization duration and postoperative recurrence rate in 6 months to 1 year etc.were recorded and compared.Results Operation time,intraoperative bleeding,postoperative hospitalization duration and postoperative fields time in the the observation group were less than the control group(P<0.05).There was no significant difference in curative effect aspects.In the postoperative follow-up(6 months to 1 year) ,the spinal instability cases in the observation group(0 case) was significantly less than the control group (6 cases).Conclusion Compared with the total laminectomy approach,the unilateral hemilaminectomy ap-proach in the treatment of subdural extramedullary tumors has more advantages as follows:better curative effect, smaller trauma, quicker recovery, fewer complications, great maintenance in spinal mobility and stability etc.
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Objective To explore the characteristics and advantages of the rat model of lumbar nerve root com -pression established via modified hemilaminectomy approach .Methods Forty Sprague Dawley ( SD) rats were randomly divided into two groups ( experimental group and control group ) for establishing a rat model of lumbar nerve root compres-sion.Modified hemilaminectomy apprpoach was used in the experimental group , while total laminectomy was applied in the control group.Duration of operation, estimated blood loss, wound healing status, postoperative mortality, motor function of the lower extremities , pathological changes and the gray level of cytoplasmic TNF-αand IL-1 expression were observed to e-valuate the characteristics and reliability of the two operation approaches in establishing a rat model of lumbar nerve root compression.Results Compared with the control group , duration of operation , estimated blood loss , wound healing sta-tus, postoperative mortality were significantly better in the experimental group (P<0.01), whereas there was non-signifi-cant difference between two groups with regard to motor function of the lower extremities , pathological changes and gray lev-el of the cytoplasmic expression of TNF-αand IL-1 between the two groups .Moreover, the soft tissue structural alterations were reduced in the experimental group , which might be helpful for the rat postoperative rehabilitation .Conclusions Modified hemilaminectomy approach is a reliable alternative method for establishing a rat model of lumbar nerve root com -pression, which is beneficial to shorten the operative time , improve wound healing status , reduce estimated blood loss and damages of soft tissue , and decrease mortality rate .Moreover , this modified method is more consistent with the principles of animal ethics .
ABSTRACT
OBJECTIVE: To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. METHODS: From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. RESULTS: The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. CONCLUSION: Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.