Limits...
Evaluations of computed tomography images and lumbar specimens in mimic operations of transverse rotation laminoplasty for lumbar spinal stenosis.

Pei XW, Liang YH, Zhang H, Gong ZS, Song HX - Chin. Med. J. (2015)

Bottom Line: The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation.In the human lumbar vertebrae specimen, the data similar to the former.The TRL provided a new alternative in the treatment of LSS.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

ABSTRACT

Background: Laminectomy is a major method to treat lumbar spinal stenosis (LSS), but it has lots of flaws such as scar tissue can form around the dura again or spinal instability. This study aimed to investigate the feasibility of transverse rotation laminoplasty (TRL) in the treatment of LSS.

Methods: The mimic operations of TRL were performed both in the computerized image processing and on the lumbar specimen. Computed tomography (CT) images were either collected from 80 clinical patients with complaints of lumbago or obtained from 40 sets of lumbar specimens after rebuild of spinal canals. In the CT image processing the heights of the spinous process and laminae at L3-L5 were measured. The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation. The areas of the vertebral canal were examined before and after the operation.

Results: In the CT images, the height of spinous process of L3, L4 and L5 was 24.74 ± 3.45, 22.68 ± 5.96 and 21.54 ± 4.12 mm respectively, and that of laminae was 23.66 ± 2.32, 22.68 ± 5.36 and 20.99 ± 3.67 mm respectively (P > 0.05). Distance of inner border of pedical of L3, L4 and L5 was 23.01 ± 6.59, 24.65 ± 5.54 and 26.03 ± 7.34 mm respectively, and length of spinous process with laminae of those was 29.76 ± 4.91, 29.31 ± 6.43 and 32.53 ± 5.76 mm respectively (P < 0.05). Preoperative area of spinal canals of L3, L4 and L5 was 299.81 ± 10.09, 297.66 ± 9.54 and 308.22 ± 10.04 mm2 respectively, and postoperative area was 480.01 ± 9.33, 487.32 ± 8.65 and 501.03 ± 9.12 mm2 respectively (P < 0.05). In the human lumbar vertebrae specimen, the data similar to the former.

Conclusions: The excised canal posterior was covered, and the lumbar canals enlarged by TRL. The TRL provided a new alternative in the treatment of LSS.

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Preoperative spinal canal.
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Figure 5: Preoperative spinal canal.

Mentions: Place the specimen L3, L4, and L5 at prone position on the operative table, First, two hinges at the junction of the lateral mass and lamina were created by thinning the dorsal cortex with surgical drill and 2 mm chisels, and then the bilateral laminae were completely cut off through the ventral cortex. The isolated spinous process and laminae edge were prepared to fit the vertebral canal. Before the laminae was removed completely, small holes were made in each lamina and in the articular process bilaterally. The spinous process and laminae was rotated by 100° at clockwise or counter-clockwise direction to rebuild a posterior wall on the spinal canal, and then were fixed by wire or titanium mini-plate [Figures 5 and 6].


Evaluations of computed tomography images and lumbar specimens in mimic operations of transverse rotation laminoplasty for lumbar spinal stenosis.

Pei XW, Liang YH, Zhang H, Gong ZS, Song HX - Chin. Med. J. (2015)

Preoperative spinal canal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837837&req=5

Figure 5: Preoperative spinal canal.
Mentions: Place the specimen L3, L4, and L5 at prone position on the operative table, First, two hinges at the junction of the lateral mass and lamina were created by thinning the dorsal cortex with surgical drill and 2 mm chisels, and then the bilateral laminae were completely cut off through the ventral cortex. The isolated spinous process and laminae edge were prepared to fit the vertebral canal. Before the laminae was removed completely, small holes were made in each lamina and in the articular process bilaterally. The spinous process and laminae was rotated by 100° at clockwise or counter-clockwise direction to rebuild a posterior wall on the spinal canal, and then were fixed by wire or titanium mini-plate [Figures 5 and 6].

Bottom Line: The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation.In the human lumbar vertebrae specimen, the data similar to the former.The TRL provided a new alternative in the treatment of LSS.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

ABSTRACT

Background: Laminectomy is a major method to treat lumbar spinal stenosis (LSS), but it has lots of flaws such as scar tissue can form around the dura again or spinal instability. This study aimed to investigate the feasibility of transverse rotation laminoplasty (TRL) in the treatment of LSS.

Methods: The mimic operations of TRL were performed both in the computerized image processing and on the lumbar specimen. Computed tomography (CT) images were either collected from 80 clinical patients with complaints of lumbago or obtained from 40 sets of lumbar specimens after rebuild of spinal canals. In the CT image processing the heights of the spinous process and laminae at L3-L5 were measured. The total length of the spinous process plus one side laminae after the operation was evaluated and compared with the length of inner margin of pedical before the operation. The areas of the vertebral canal were examined before and after the operation.

Results: In the CT images, the height of spinous process of L3, L4 and L5 was 24.74 ± 3.45, 22.68 ± 5.96 and 21.54 ± 4.12 mm respectively, and that of laminae was 23.66 ± 2.32, 22.68 ± 5.36 and 20.99 ± 3.67 mm respectively (P > 0.05). Distance of inner border of pedical of L3, L4 and L5 was 23.01 ± 6.59, 24.65 ± 5.54 and 26.03 ± 7.34 mm respectively, and length of spinous process with laminae of those was 29.76 ± 4.91, 29.31 ± 6.43 and 32.53 ± 5.76 mm respectively (P < 0.05). Preoperative area of spinal canals of L3, L4 and L5 was 299.81 ± 10.09, 297.66 ± 9.54 and 308.22 ± 10.04 mm2 respectively, and postoperative area was 480.01 ± 9.33, 487.32 ± 8.65 and 501.03 ± 9.12 mm2 respectively (P < 0.05). In the human lumbar vertebrae specimen, the data similar to the former.

Conclusions: The excised canal posterior was covered, and the lumbar canals enlarged by TRL. The TRL provided a new alternative in the treatment of LSS.

Show MeSH
Related in: MedlinePlus