Hemilaminectomy for the removal of the spinal lesions

Abstract

Objective: We evaluated 20 patients with spinal lesions with respect to the value of unilateral hemilaminectomy at the Department of Neurosurgery, Erciyes University, Medical Faculty, Kayseri, Turkey. The operative technique of the limited approach for spinal lesions is described. Methods: The study is based on 20 prospective consecutive patients with spinal lesions who had unilateral hemilaminectomy. There were 12 women and eight men. Age ranged from 17 to 63 years mean (42 years) with a slight preponderance of women patients (60%). Spinal lesions were cervical in three cases, lumbar in ®ve cases, and thoracic in 12 cases. Hemilaminectomy was performed by using a high speed drill. Results: Postoperative neurological status was unchanged in six cases, improved in 11 cases, and worsened in three cases. We only observed two cases of wound infections that were not related to our surgical approach. At the follow-up evaluation, which occurred approximately 25 months after surgery none of the patients showed spinal deformity or spinal instability. Conclusion: The rationale of attempting unilateral approach is to avoid damage to the dorsal static structures of the vertebral column. With the precise preoperative de®nition of the relationship of tumor to the surface of the spinal cord by contrast enhanced MRI, unilateral approaches might be more applicable to spinal lesions except invasive extradural lesions. Spinal Cord (2000) 38, 92 ± 96

Minimally invasive approach for the treatment of intradural spinal pathology

“…This approach has been associated with fewer complications, better outcomes, and shorter hospital stays. 2,7,10,13,14 In our series, only 1 patient underwent fusion at the time of surgery (Case 3) because the entire facet was removed to reach the tumor. One patient required anterior cervical discectomy and fusion for degenerative disc disease, but this was to treat a preexisting condition.…”

“…This approach has been modified with hemilaminectomy and partial facetectomy to reduce the risk of postoperative pain and subsequent spinal deformity. 2,7,13 The use of MIS approaches has been well described for the treatment of degenerative spinal disease. These techniques are now being adopted and modified for the treatment of intradural pathology.…”

Intradural arachnoid cyst associated with thoracic spinal compression fracture: 7-year follow up after surgery

“…On the other hand, hemilaminectomy should not result in postoperative spinal deformity and instability. 15,16 The rationale for choosing a unilateral approach is to preserve the midline ligamentous structure and the posterior supporting structures on the contralateral site. Hemilaminectomy combined with microsurgical techniques should be given priority over standard laminectomy in the surgical management of extramedullary lesions arising in the spinal canal.…”

The use of minimally invasive approaches to resect intradural extramedullary spinal cord tumors

“…I. Oktem и соавт. [20] опубликовали опыт лечения 20 пациентов с интрадуральными опу-холями с использованием гемиламинэктомии в каче-стве доступа в 2000 г. За 2 года наблюдения ни в од-ном случае не выявлено развитие нестабильности сегментов позвоночного столба.…”