Expansive laminoplasty for lumbar intradural lipoma

Matsui, Hisao; Koike, Masahiko; Miaki, Kentaro

doi:10.1007/s002640050147

Cited by 17 publications

(14 citation statements)

References 9 publications

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“…More recently, several studies reported the usefulness of lamina reconstruction for treating spinal or spinal cord injury, achieving good clinical and biomechanical outcomes (25,26). In the present study, the method of lamina reconstruction based on one-stage posterior debridement, limited decompression, bone grafting and internal fixation was used to treat monosegmental spinal TB in group A and good clinical efficacy was achieved.…”

Section: Discussionmentioning

confidence: 77%

Two one-stage posterior approaches for treating thoracic and lumbar spinal tuberculosis: A retrospective case-control study

Zhang¹,

Wang²,

Shen³

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of this retrospective study was to analyze the results of two surgical treatments for thoracic and lumbar spinal tuberculosis. A total of 73 patients with monosegmental thoracic or lumbar spinal tuberculosis were enrolled from January 2006 to April 2011. The patients were divided into two groups. Patients in group A (n=34) underwent one-stage posterior debridement, limited decompression, bone grafting and internal fixation combined with lamina reconstruction, while those in group B (n=39) underwent one-stage posterior debridement, decompression, bone grafting and posterior instrumentation. Clinical and radiographic results were analyzed and compared between the groups. Patients were followed for a mean 31.3 months (range, 21-42 months). Fusion occurred at 4-12 months (mean, 7.7 months). Surgical complications affected one and five patients in groups A and B, respectively. There was extraction of internal fixation in two group B patients. Postoperatively, there was significant Cobb angle correction in the two groups. By the last follow-up, the Cobb angle and correction loss in group A were significantly better than that in group B; the group A Oswestry Disability Index and Frankel grade were better than that in group B.In conclusion, one-stage posterior limited decompression, bone grafting and internal fixation combined with lamina reconstruction enables rapid management of monosegmental thoracic and lumbar spinal tuberculosis with fewer complications and minimal invasion. IntroductionAs the most common form of extrapulmonary tuberculosis (TB), spinal TB has remained prevalent worldwide, particularly in the less developed and developing countries (1,2), occurring in 1.7% of the world population (3) and accounting for almost 50% of cases of skeletal TB (4). Additionally, it can be the most dangerous form of skeletal TB due to its capacity for causing bone destruction, deformity and paraplegia (5). Anti-tuberculous chemotherapy has proven effective in the majority of cases and has become the mainstay of treatment (6), yet it cannot prevent kyphotic degeneration (7,8). Surgery is therefore frequently imperative for spinal decompression (9).Various surgical methods have been described for treating spinal TB. While there are advantages to exposing the pathological site directly and resecting damaged vertebrae, sequestra of disc and bone, and tuberculous granuloma, which cause predominantly anterior compression of the spinal cord, have led certain authors (10,11) to consider the anterior approach too invasive and often unnecessary in the context of spinal TB. The anterior approach may also involve division of the diaphragm and segmental spinal vessels. An increasing number of surgeons have adopted the method of posterior debridement, bone fusion and posterior fixation to treat monosegmental spinal TB. However, complications resulting from damage to the posterior spinal column due to the posterior approach reduce the surgical effect and affect the patient's quality of life (12). A procedure that caused...

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Section: Discussionmentioning

confidence: 77%

Two one-stage posterior approaches for treating thoracic and lumbar spinal tuberculosis: A retrospective case-control study

Zhang¹,

Wang²,

Shen³

et al. 2015

Experimental and Therapeutic Medicine

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“…Inclusion of the misplaced adipocytes during the formation of the neural tube causes growth of lipoma in the spinal cord. 1,3,4,[6][7][8][9][10] . This is not a true neoplasm but a hamatoma or a malformation.…”

Section: Discussionmentioning

confidence: 99%

“…Connective tissue metaplasia may lead to deposition of fat within the dura. 8,9 The third is 'hamartomatous origin theory'. The fat tissue can include peripheral nerve twig, dermoid cyst, skeletal muscles and lymphoid or renal tissue, which originate from ectoderm or mesoderm.…”

Section: Discussionmentioning

confidence: 99%

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Spinal intramedullary lipoma: report of three cases

et al. 2003

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Study design: Case report. Objective: To report three cases of spinal intramedullary lipoma seen in the last 10 years and present the clinical characteristics and surgical outcome of these cases. Method: Two patients were boys aged 12 years and 7 months, respectively. The other was a female patient aged 6 months. Chief complaints were hemiparesis, back swelling and thoracic scoliosis. All patients were diagnosed with magnetic resonance images. The lesion was located in the cervico-thoracic spine (foramen magnum to T1) in one case, thoracic spine (T9ÀT12) with the back swelling at L2-4 level in the second, and in the third, one mass extended from C6 to T11 and the other mass was located in the L1-2 level, separately. Result: All masses were removed subtotally and dysraphism was absent. Postoperatively, neurological status of the first and the second patient were unchanged, but in the third case weakness was transiently aggravated. Conclusion: Intramedullary lipoma is a rare spinal lesion and multiple intramedullary lipoma is extremely rare. Treatment principle is surgical decompression before symptom progression. Laminoplastic laminotomy is an appropriate approach for decompression of an intramedullary lipoma.

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“…1), postoperative instability, subluxation or a kyphotic deformity of the spine, especially in pediatric patients [2,3,7,16,17]. Recently, several investigators have reported the usefulness of laminoplasty to reconstruct the excised laminae for the extirpation of spinal cord and cauda equina tumors [9,14,15]. Laminoplasty allows surgeons to compensate for several difficulties encountered during a laminectomy.…”

Section: Introductionmentioning

confidence: 99%