Clinical Efficacy of Laminectomy with Instrumented Fixation in Treating Thoracolumbar Intradural Extramedullary Schwannomas: A Comparative Study
Haoming Wang, Yachong Huo, Liang Li, Xiaobing Liu, Dalong Yang, Wenyuan Ding, Sidong Yang
Department of Spine Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
Med Sci Monit 2020; 26:e921719
DOI: 10.12659/MSM.921719
Available online: 2020-04-10
Published: 2020-06-09
BACKGROUND:
This study investigated the clinical effect of laminectomy plus pedicle screw fixation in treating thoracolumbar intradural extramedullary schwannomas.
MATERIAL AND METHODS:
Between October 2011 and May 2017, 57 patients undergoing resection of thoracolumbar schwannomas were retrospectively identified and included in the study. Based on the surgical procedures used, all participants were assigned to either the laminectomy-only group (n=33) or the combination group (laminectomy plus pedicle screw fixation, n=24). All participants were followed up for over 2 years. In the laminectomy, the spinal process, vertebral laminae, and bilateral upper articular processes of the surgical segments were completely resected and the lower articular processes were reserved. For further analysis, we evaluated the pain levels using visual analogue scale (VAS) score. The assessment of neurological function was performed with Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI). The comparisons of Cobb angle changes were carried out pre-surgery and post-surgery.
RESULTS:
The demographic data were well matched between the laminectomy-only group and combination group, without significant differences (P>0.05). After surgery, both surgical procedures achieved significant improvement in VAS score, ODI, and JOA score (P<0.001), but no significant differences were found between these 2 surgical procedures (P>0.05). The postoperative change in Cobb angle indicated a significant difference in the laminectomy-only group, but not in the combination group (P<0.05). In addition, postoperative spinal instability/deformity was found in the laminectomy-only group (P<0.05).
CONCLUSIONS:
In conclusion, the combination of laminectomy and pedicle screw fixation is a safe and effective surgical procedure when used to treat thoracolumbar schwannoma, and appears to be superior to the laminectomy-only procedure.
Keywords: Laminectomy, Neurilemmoma, Spine, Surgical Instruments
