Cervical Hemilaminoplasty: Technical Note

Kato, Yoshihiro; Kataoka, Hideo; Kojima, Takanori; Imajyo, Yasuaki; Taguchi, Toshihiko

doi:10.1097/01.bsd.0000211287.98895.a3

Cited by 8 publications

(11 citation statements)

References 13 publications

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“…Furthermore, it allowed reconstruction of the posterior element of the spinal canal with good results in stability. In 2007, Kato [22] proposed this posterior approach method for spinal tumors, recommending it especially for dumbbell type tumors.…”

Section: Discussionmentioning

confidence: 99%

Less invasive approaches for the treatment of cervical schwannomas: our experience

et al. 2011

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Purpose The purpose of our paper is to illustrate our experience with minimally invasive approaches for the treatment of cervical schwannomas. Moreover, a brief review of the literature was conducted. Methods All data regarding patients treated for cervical schwannomas were retrospectively revised. Site, size and extension of the lesions and preoperative neurological status were obtained through re-examination of neuroimaging and clinical records. Postoperative clinical examinations and radiological images were available for all patients. The clinical course was documented using the visual analog scale (VAS), Karnofsky score (KPS) and the Klekamp-Samii score system. Results Sixteen patients harboring cervical schwannomas were treated from 2003 to 2009. Hemilaminectomy was performed in eight cases, subtotal hemilaminectomy in four cases, interlaminar fenestration in two cases, osteoplastic hemilaminotomy and laminoplasty in one case each. Postoperative neuroimaging revealed complete removal of the lesion and no signs of spinal instability. At discharge, neurological improvement was observed in 14 patients and all patients demonstrated reduction of VAS score and improvement of KPS and Klekamp-Samii's score. Conclusions Minimal access procedures are increasingly gaining popularity but their use is poorly described in the treatment of cervical tumors. Less invasive approaches may effectively be used instead of traditional laminectomy in the treatment of cervical tumors, especially schwannomas, providing less iatrogenic traumatism and preventing postsurgical spinal instability. Modern neuroimaging allows adequate preoperative planning and microsurgical techniques provide adequate execution of the surgical act. The procedure has to be tailored case by case considering the specific lesional features and the individual anatomical situation.

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Section: Discussionmentioning

confidence: 99%

Less invasive approaches for the treatment of cervical schwannomas: our experience

et al. 2011

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“…To avoid the postoperative complications various types of surgical techniques have been developed. 6,9,12,15 The main objective of these innovations to preserve and reconstruct the posterior spinal structures. Beyond the disadvantageous effect of the multilevel approaches the preservation of the anatomical and functional spinal segment is highlighted in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…New minimal invasive spine surgery techniques have been developed with the goal to achieve better clinical outcomes, with the preservation of the dynamic and static stabilizing structures of the spinal column in treatment of the segmental-lateral pathologic lesions. 8,9,[11][12]17 The purpose of our retrospective study is to summarize the minimal invasive procedures with describing technical features, advantages, complications and clinical outcomes for treating segmental-lateral pathologies, located in the spinal canal, in the neuroforamen, or even paravertebraly. 3,5,13,[14][15][16] …”

Section: Introductionmentioning

confidence: 99%

“…[7][8]10,21 Several surgical techniques found in the literature to preserve the posterior structures, but most of them focused on multilevel spinal pathologies. 4,6,9,11,12,18 One spinal segment consists of the two joining vertebras with all of the ligaments and muscles connecting them to each-other. Our novel classification system for treatment of spinal disorders based on the intraspinal localization of pathologic lesions.…”

Section: Introductionmentioning

confidence: 99%

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Novel minimal invasive surgical techniques for the treatment of segmental-lateral pathologic lesions of the spine, preserving the dorsal stabilizing structures

Papp¹,

Vajda²,

Veres³

et al. 2013

Biomech Hung

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Objective: Laminectomy, the commonly used dorsal approach for the surgical removal of most of the pathologic lesions, situated in the spinal canal and the neuroforamen destroying the dorsal stabilizing structures of the spinal column. Retraction and detachment of the longitudinal muscles, removal of the vertebral arches (laminectomy), and injury of the joint capsules and ligaments are responsible most of short and late-time complications. Among of these complications spinal deformities, segmental instability and permanent spinal pain are most often mentioned in the literature.The main objective of the authors was to develop and evaluate the novel minimally invasive techniques suitable for exploring and treating different segmental-lateral pathologies, expanding to the neuroforamen or even paravertebraly, with preservation of the stability of the spine. One of the key issues of this article was to summarize these procedures, with evaluating the safety and efficacy in the routine spine surgery.Methods: 153 patients were operated and followed up during 2000 to 2010 in our Institute with segmental lateral spinal pathologies. For the surgical treatment we used "Over-the-top" decompression, hemi-semi laminectomy, supraforaminal burr-hole, open-tunnel and paravertebral approaches alone or combined with each-other. The above mentioned surgical techniques are mostly our developments, or modifications of previously used surgical techniques.Results: The new surgical procedures developed or modified by our team, are effective techniques for treating the spinal pathologies located in the spinal canal, neuroforamen or even the paravertebral space. The posterior stabilizing structures of the spine, as the vertebral laminae and the longitudinal musculature are mostly preserved. Leaving the longitudinal paraspinal musculature innervations intact, and with the preservation of the bone-muscle attachments and ligaments, the dynamic stability of the spine remains unchanged. Retaining the bony structures (vertebral arches) and the vertebral joints the static stability of the spinal column remain intact, the chance of developing the long-term spinal deformation is minimal.During the follow up we performed static and dynamic X-ray, MR and CT scans, completed with neurological examinations to evaluate the progression of the illness, the neurological deficit and the actual state of the spinal column. With clinical use and evaluation of the various surgical approaches we determined the main indications and contraindications of the surgical procedures, highlighting the pit-falls and limitations.Conclusion: The above mentioned minimally invasive surgical approaches are suitable for treating segmental -lateral spinal pathologies. . For the routine clinical use we organized the surgical techniques into a complete framework based on the location of the pathologic lesions.

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“…The cutting of laminae is performed on the laminae and the ligamentum flavum. Otherwise, the lamina is cut obliquely at pars interarticularis using the T-saw and the spatula in Kato's Technique (8). In our opinion, this method damages the facet joints.…”

Section: A B a Bmentioning

confidence: 99%

Cervical hemilaminoplasty with miniplates in long segment intradural extramedullary ependymoma: case report and technical note

Oral

Tümtürk²,

Küçük³

et al. 2015

Turkish Neurosurgery

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ABSTRACTtumor location. Ependymomas are the most common tumors of the spinal cord in adults. Furthermore, intradural extramedullary (IDEM) ependymomas are very rare (10). Pain is the most common symptom among patients with IDEM ependymomas. Other symptoms are motor disorders, sensual disorders and sphincter disorders. Neurological symptoms gradually arise in these patients. The most valuable diagnostic technique is magnetic resonance imaging (MRI). An ependymoma may cause expansion of the spinal cord, which may enhance following intravenous injection of gadolinium. The role of surgery in the management of intramedullary tumors has evolved █ INTRODuCTION S pinal cord tumors account for about 15% of central nervous system neoplasms. Spinal tumors are divided into three major groups according to location: intramedullary, intradural extramedullary, and extradural. Intrinsic intramedullary tumors are uncommon and less frequent than extradural or intradural extramedullary tumors. Therefore, intramedullary tumors are rare, accounting for only 5 to 10% of all spinal tumors (3). The two most common intramedullary tumors of the spinal cord are ependymoma and astrocytoma. Specific clinical signs and symptoms are variable and largely determined byThe surgical approaches for spinal tumors, to a great extent, have been developed in accordance with the developments in medical technology. Today, many surgical techniques are implemented as anterior, anterolateral, posterior, posterolateral and combined approaches. Due to its low morbidity, the posterior approach is the more preferred one. Laminectomy is a widely used technique, especially in neoplastic lesions. However, following laminectomy, there are numerous complications such as instability, kyphotic deformity and scar formation. In this paper, the excision of a tumor that was located intradural-extramedullary at the C3-C7 level with the cervical hemilaminoplasty technique is described. A 47-year-old female patient presented to our clinic with increasing complaints of neck and left arm pain, left arm numbness and searing pain for the last 10 years. On examination, hypoesthesia at the C4-7 dermatomes in the left upper extremity, an increase in deep tendon reflexes, and bilateral positive Hoffmann reflexes were observed. C3-C7 laminae were opened unilaterally on the right side with a midline skin incision. The laminae were drilled with a high-speed drill to provide a wide opening, both on the midline obliquely and from the border of the lamina-facet joint. After the tumor was totally excised, hemilaminae were placed into the previous position and reconstructed with mini-plates and screws. Cervical hemilaminoplasty provides a wide field of vision in tumor surgery of this region. Besides, the reconstruction of hemilaminae is important for stability. As the integrity of the spinal canal is preserved during reoperations of this region, the risk of complications is decreased.

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Cervical Hemilaminoplasty: Technical Note

Cited by 8 publications

References 13 publications

Less invasive approaches for the treatment of cervical schwannomas: our experience

Less invasive approaches for the treatment of cervical schwannomas: our experience

Novel minimal invasive surgical techniques for the treatment of segmental-lateral pathologic lesions of the spine, preserving the dorsal stabilizing structures

Cervical hemilaminoplasty with miniplates in long segment intradural extramedullary ependymoma: case report and technical note

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