Laminectomy vs Fusion for Intradural Extramedullary Tumors

Kevin Mo; Jessica Mazzi; Rohan Laljani; Carlos Ortiz-Babilonia; Kevin Y Wang; Micheal Raad; Farah Musharbash; Humaid Al Farii; Sang Hun Lee

doi:10.14444/8430

Laminectomy vs Fusion for Intradural Extramedullary Tumors

Int J Spine Surg. 2023 Apr;17(2):198-204. doi: 10.14444/8430. Epub 2023 Mar 28.

Authors

Kevin Mo¹, Jessica Mazzi², Rohan Laljani³, Carlos Ortiz-Babilonia³, Kevin Y Wang³, Micheal Raad³, Farah Musharbash³, Humaid Al Farii³, Sang Hun Lee³

Affiliations

¹ Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA kevinchowahmo@gmail.com.
² Western University of Health Sciences, Pomona, CA, USA.
³ Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.

PMID: 36977535
PMCID: PMC10165638
DOI: 10.14444/8430

Abstract

Background: Laminectomy (LA) and LA with fusion (LAF) have been demonstrated as surgical techniques that treat intradural extramedullary tumors (IDEMTs). The purpose of the present study was to compare the rate of 30-day complications following LA vs LAF for IDEMTs.

Methods: Patients undergoing LA for IDEMTs from 2012 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients undergoing LA for IDEMTs were substratified into 2 cohorts: those who received LAF and those who did not. In this analysis, preoperative patient characteristics and demographic variables were assessed. 30-day wound, sepsis, cardiac, pulmonary, renal, and thromboembolic complications, as well as mortality, postoperative transfusions, extended length of stay, and reoperation, were assessed. Bivariate analyses, including χ ² and t tests, and multivariable logistical regression were performed.

Results: Of 2027 total patients undergoing LA for IDEMTs, 181 (9%) also had fusion. There were 72/373 (19%) LAF in the cervical region, 67/801 (8%) LAF in the thoracic region, and 42/776 (5%) LAF in the lumbar region. Following adjustment, patients who received LAF were more likely to have increased length of stay (OR 2.73, P < 0.001) and increased rate of postoperative transfusion (OR 3.15, P < 0.001). Patients undergoing LA in the cervical spine for IDEMTs tended to receive additional fusion (P < 0.001).

Conclusions: Increased length of stay and rate of postoperative transfusion were associated with LAF for IDEMTs. LA in the cervical spine for IDEMTs was associated with additional fusion.

Keywords: cancer; fusion; intradural extramedullary; laminectomy; spine surgery.

This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.