Laminectomy without instrumentation for surgical treatment of metastatic spinal cord compression

Abstract

Objective: To analyze the development of mechanical complications as a result of spinal decompression or cauda equina in patients with metastatic tumors of the spine via laminectomy or laminoartrectomy without fixation. Methods: We studied the medical records of all patients submitted to spine decompression with laminectomy without fixation. The decompression was indicated to treat cord compression or cauda equina caused by metastatic tumors. Patients were evaluated for the development of postoperative mechanical instability by comparing the preoperative radiological examinations with the latest one available in the medical record review.. In these images, we evaluated the emergence of new deformity in the sagittal or coronal planes and translational deformity. We consider new deformity, signs of deformity greater or equal to 5° in the coronal or sagittal planes and signs of increased vertebral translation greater than or equal to 3 mm. Results: No patient developed radiological instability in the period evaluated with an average follow-up of 163.24 days (3-663). The complication rate in our sample was not higher than the previously reported in the literature. Conclusion: Isolated laminectomy at one or more levels is a safe procedure for the treatment of metastatic spinal cord compression where the spine is judged stable before surgery.