Comparison of microscopic full-laminectomy (open surgery) and microendoscopic minimally invasive hemilaminectomy for thoracic extramedullary spinal tumours

Abstract

Abstract Background Minimally invasive treatments for spinal cord tumours are common. The aim of this study was to compare the perioperative outcomes of patients with thoracic extramedullary spinal tumours (TEST) treated by microendoscopic minimally invasive surgery—hemilaminectomy through a homemade tubular retractor (MIS-TR) and microscopic full laminectomy (open surgery). Methods Between February 2016 and February 2021, 51 patients with TEST were included. According to their clinical data, patients were classified into the MIS-TR group (n = 30) and the open surgery group (n = 21) and assessed. Results In both groups, the mean operation time, change in perioperative ASIA score, and modified Macnab score were comparable. The average postoperative hospital stay in the MIS-TR group was substantially shorter than that in the open surgery group (p < 0.0001). The mean blood loss volume in the MIS-TR group was substantially lower than that in the open surgery group (p = 0.001). The perioperative complication rate in the MIS-TR group was considerably lower than that in the open surgery group (p < 0.0001). At the 3-month follow-up, there was no substantial difference in the Oswestry Disability Index (ODI) score improvement between the two groups. Nonetheless, at the 12-month follow-up, the average ODI in the MIS-TR group was considerably lower than that in the open surgery group (p = 0.023). The main influencing factors for complete postoperative recovery were preoperative ASIA score (OR 7.848, P = 0.002), surgical complications (OR 0.017, P = 0.008) and age (OR 0.974, P = 0.393). Conclusions MIS-TR is safer and more effective than open surgery for treating TEST, but the long-term recovery of MIS-TR is not better than that of open surgery.

Keywords

• Endoscopic surgery
• Tubular retractor
• Thoracic spinal tumours
• Minimally invasive