title: Retrospective observational comparative study of Hemilaminectomy versus Laminectomy for intraspinal tumour resection; Shorter Stays, Lower Analgesic Usage and Less Kyphotic Deformity.
abstract: BACKGROUND
  Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less post-operative pain.
  
  
  METHODS
  We investigated this hypothesis by retrospectively reviewing a case series of 56 surgeries for a disparate and unselected group of intraspinal tumours utilizing a laminectomy or hemilaminectomy approach.
  
  
  RESULTS
  No difference was found in length of operation, completeness of resection, complication rate and Frankel-score improvements. Hemilaminectomy (n = 22) is associated with reduced hospital stay (post-op days) 4.5 (2-6) versus 6 (3-8), (p = 0.026, Mann-Whitney), and a reduction in post-operative morphine use (mg) 10 (3.5-28) versus 30 (10-90), (p = 0.005, Mann-Whitney). Post-operative kyphosis was measured with the Harrison posterior tangent method on T2-weighted sagittal MR images. The average change in kyphosis angle was greater in the laminectomy group compared with the hemilaminectomy group, 3.6 (0.8-6.2) versus 0.4 (-0.2-1.2), statistically significant (p = 0.004, Mann-Whitney).
  
  
  CONCLUSIONS
  Hemilaminectomy is as effective an access procedure for the resection of unselected intraspinal tumours as laminectomy, but is associated with shorter post-operative stays, lower analgesic requirements and less post-operative kyphosis.
authors.affiliation: Barts and The London School of Medicine and Dentistry , Whitechapel, London , UK.
authors.forename: Christopher Paul
authors.initials: CP
authors.lastname: Millward
authors.forename: Dolin
authors.initials: D
authors.lastname: Bhagawati
authors.forename: Huan Wee
authors.initials: HW
authors.lastname: Chan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bestwick
authors.forename: John Edward
authors.initials: JE
authors.lastname: Brecknell
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D007796:Laminectomy / Q000379:methods; D008297:Male; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
keywords: analgesia; hemilaminectomy; hospital stay; intraspinal tumour; kyphosis; laminectomy