E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Para-split Laminotomy versus Hemilaminectomy for the Removal of Lumbar Spinal Tumors: Short- to Mid-term Clinical Outcomes
Lunyuan Zhang✉ ,
Hao Peng ,
Wenyong Gao ,
Zhengcun Yan ,
Yuping Li ,
Min Wei ,
Xingdong Wang ,
Can Tang ,
Hengzhu Zhang ,
Xiaodong Wang
Department of Neurosurgery, Northern Jiangsu People\'s Hospital Afiliated to Yangzhou University; Neurosurgery, Yangzhou University; Neurosurgery, Northern Jiangsu People's Hospital
Accepted: 20/08/2026
Article in Press
Corresponding Author:
Lunyuan Zhang (zhanglunyuan2024@163.com)
Abstract
Aim
To compare the short- to mid-term clinical outcomes of para-split laminotomy (PL) and hemilaminectomy (HL) for the resection of lumbar spinal tumors.
Material and Methods
We retrospectively reviewed 67 patients who underwent lumbar spinal tumor resection between October 2016 and December 2019. Thirty-five patients received PL and 32 received HL. Perioperative variables, postoperative Visual Analog Scale scores, Japanese Orthopaedic Association (JOA) scores and recovery rates, paravertebral muscle (PVM) atrophy on magnetic resonance imaging, and coronal and sagittal spinal alignment were assessed. All patients were followed for at least 36 months.
Results
Operative time was longer in the PL group than in the HL group (181.1 ± 34.8 vs 164.2 ± 33.7 min, P=0.047), whereas blood loss was lower (100 [75–140] vs 125 [100–175] mL, P=0.041). The PL group had lower pain scores on postoperative days 4 and 7, shorter bed-rest duration, and shorter hospital stays. At 6 months, JOA scores and recovery rates were higher in the PL group, but no between-group differences were observed at 12 or 36 months. At 12 months, PVM atrophy was lower after PL (15.9 ± 6.0% vs 20.5 ± 7.0%, P=0.004). Changes in coronal Cobb angle and lumbar lordosis were similar between groups.
Conclusion
PL may provide perioperative and muscle-preserving advantages while achieving neurological and spinal alignment outcomes comparable to HL at mid-term follow-up. It appears to be a feasible alternative for selected lumbar spinal tumors with well-defined margins, although larger prospective studies are needed.
To compare the short- to mid-term clinical outcomes of para-split laminotomy (PL) and hemilaminectomy (HL) for the resection of lumbar spinal tumors.
Material and Methods
We retrospectively reviewed 67 patients who underwent lumbar spinal tumor resection between October 2016 and December 2019. Thirty-five patients received PL and 32 received HL. Perioperative variables, postoperative Visual Analog Scale scores, Japanese Orthopaedic Association (JOA) scores and recovery rates, paravertebral muscle (PVM) atrophy on magnetic resonance imaging, and coronal and sagittal spinal alignment were assessed. All patients were followed for at least 36 months.
Results
Operative time was longer in the PL group than in the HL group (181.1 ± 34.8 vs 164.2 ± 33.7 min, P=0.047), whereas blood loss was lower (100 [75–140] vs 125 [100–175] mL, P=0.041). The PL group had lower pain scores on postoperative days 4 and 7, shorter bed-rest duration, and shorter hospital stays. At 6 months, JOA scores and recovery rates were higher in the PL group, but no between-group differences were observed at 12 or 36 months. At 12 months, PVM atrophy was lower after PL (15.9 ± 6.0% vs 20.5 ± 7.0%, P=0.004). Changes in coronal Cobb angle and lumbar lordosis were similar between groups.
Conclusion
PL may provide perioperative and muscle-preserving advantages while achieving neurological and spinal alignment outcomes comparable to HL at mid-term follow-up. It appears to be a feasible alternative for selected lumbar spinal tumors with well-defined margins, although larger prospective studies are needed.
Keywords
Split laminectomy
Hemilaminectomy
Intraspinal tumors
Spine surgery