Clinical Efficacy of Laminectomy with Instrumented Fixation in Treating Thoracolumbar Intradural Extramedullary Schwannomas: A Comparative Study
- 9 June 2020
- journal article
- research article
- Published by International Scientific Information, Inc. in Medical Science Monitor
- Vol. 26, e921719-e921719-9
- https://doi.org/10.12659/MSM.921719
Abstract
Background: This study investigated the clinical effect of laminectomy plus pedicle screw fixation in treating thoracolumbar intradural extramedullary schwannomas. Material/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, with- out significant differences (P>0.05). After surgery, both surgical procedures achieved significant improvement in VAS score, ODI, and JOA score (P0.05). 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
This publication has 31 references indexed in Scilit:
- Treatment Results in the Differential Surgery of Intradural Extramedullary Schwannoma of 110 CasesPLOS ONE, 2013
- Ossification of the ligamentum flavum of the thoracic spine in the Korean populationJournal of Neurosurgery: Spine, 2011
- Mobility of Intradural Extramedullary Schwannoma at Spine : Report of Three Cases with Literature ReviewJournal of Korean Neurosurgical Society, 2010
- Posterior decompression surgery for extraforaminal entrapment of the fifth lumbar spinal nerve at the lumbosacral junctionJournal of Neurosurgery: Spine, 2010
- Clinical Characteristics of Spinal Nerve Sheath Tumors: Analysis of 149 CasesNeurosurgery, 2005
- Surgical experience with symptomatic thoracic ossification of the ligamentum flavumJournal of Neurosurgery: Spine, 2005
- Long-term outcome after removal of spinal schwannoma: a clinicopathological study of 187 casesJournal of Neurosurgery, 1995
- Intradiscal Pressure Measurements Above an Instrumented FusionSpine, 1995
- Magnetic Resonance Imaging Assessment of Disc Degeneration 10 Years After Anterior Lumbar Interbody FusionSpine, 1995
- Radiologic Diagnosis of Degenerative Lumbar Spinal InstabilitySpine, 1985