title: The role of laminoplasty in preventing spinal deformity in adult patients submitted to resection of an intradural spinal tumor. Case series and literature review.
abstract: OBJECTIVE
  Laminectomy has normally been used as a standard approach for intradural spinal tumors but this procedure is associated with spinal instability and deformity. Laminoplasty was developed to overcome these limitations. Controversies still exist regarding its actual role in preventing spinal deformity in adults. The aim of our study was to determine the impact of laminoplasty on the prevention of spinal deformity's onset or worsening in adult patients submitted to intradural spinal tumors resection.
  
  
  METHODS
  We retrospectively reviewed the data of 43 consecutive adult patients, who underwent either laminectomy or laminoplasty for spinal intradural tumor resection, between January 2006 and May 2011. We evaluated the role of sex, spinal segment (cervical, thoracic, lumbar), tumor location (intra- or extra-medullary), procedure (laminoplasty or laminectomy), number of treated levels (≤2 vs >2), presence of pre-operative deformity and pre-operative Modified McCormick Scale (≤2 vs >2) in the development or worsening of spinal deformity, using Fisher's exact test and multivariate logistic regression analysis.
  
  
  RESULTS
  Nine patients developed deformity or experienced a worsening of pre-operative deformity at latest follow-up. Among the considered potential prognostic factors, laminectomy (p=0.03) and evidence of pre-operative spinal deformity (p=0.009) were significantly associated with new-onset or worsening of spinal deformity. At logistic regression analysis, only the performed surgical procedure emerged as independent prognostic factor (p=0.044). No CSF leak was recorded in the laminoplasty cohort.
  
  
  CONCLUSIONS
  No new-onset spinal deformities, no CSF leaks and a lower rate of spinal deformity progression were observed after laminoplasty for intradural intra- or extra-medullary tumor resection.
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy. Electronic address: nicolamontanomd@yahoo.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Trevisi
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Cioni
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Lucantoni
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Della Pepa
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Meglio
authors.affiliation: Institute of Neurosurgery, Catholic University, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Papacci
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control* / Q000601:surgery; D007796:Laminectomy / Q000379:methods; D065406:Laminoplasty / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D055815:Young Adult
keywords: CSF leak; Intradural spinal tumor; Laminectomy; Laminoplasty; Spinal deformity