title: [EFFECTIVENESS OF POSTERIOR MIDLINE APPROACH WITH COMPLETE LAMINECTOMY FOR GIANT INTRASPINAL TUMOR RESECTION AND VERTEBRAL CANAL RECONSTRUCTION].
abstract: OBJECTIVE
  To investigate the effectiveness of the posterior midline approach with complete laminectomy for giant intraspinal tumor (more than 3 cm in diameter) resection and vertebral canal reconstruction.
  
  
  METHODS
  Between March 2009 and February 2012, 21 cases of giant intraspinal tumor underwent the posterior midline approach with complete laminectomy and vertebral canal reconstruction. There were 12 males and 9 females with an average age of 40.5 years (range, 21-62 years). The Japanese Orthopaedic Association (JOA) scores were 0-5 in 4 cases, 6-11 in 9 cases, and 12-17 in 8 cases. The preoperative Cobb angle was less than 10° on the X-ray films. MRI showed that the tumor located at the cervical part in 3 cases, at the cervicothoracic part in 1 case, at the thoracic part in 8 cases, at the thoracolumbar part in 2 cases, and at the lumbar part in 7 cases; the long diameter of tumor on the sagittal view was 3.0-16.5 cm (mean, 8.3 cm). Total resection of tumor was performed in 17 cases, and subtotal resection in 4 cases.
  
  
  RESULTS
  Postoperative pathological examinations showed 9 cases of neurilemmoma, 6 cases of neurofibroma, 3 cases of lipoma, 2 cases of meningioma, and 1 case of bronchogenic cyst. Primary healing of incision was achieved in all patients. The patients were followed up 1-3 years (mean, 2.3 years). Postoperative X-ray film showed that Cobb angle was more than 10° in 3 cases, and no displacement of internal fixator was observed. The JOA scores were 0-5 in 1 case, 6-11 in 10 cases, and 12-17 in 10 cases, showing significant difference when compared with preoperative scores (Z = -3.26, P = 0.02).
  
  
  CONCLUSIONS
  The posterior midline approach with complete laminectomy for giant intraspinal tumor resection and vertebral canal reconstruction is a safe, simple, and feasible operation way, and it can resect tumor to a maximum extent, relieve the clinical symptoms, and maintain the spinal stability.
authors.forename: Xuanxuan
authors.initials: X
authors.lastname: Wu
authors.forename: Haisong
authors.initials: H
authors.lastname: Li
authors.forename: Chengyuan
authors.initials: C
authors.lastname: Ma
authors.forename: Yi
authors.initials: Y
authors.lastname: Guan
authors.forename: Yiping
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma; D011183:Postoperative Complications; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D013115:Spinal Canal; D013125:Spinal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome