Midline spinous process splitting laminoplasty in a newborn with thoracolumbar epidural hematoma: a bone-sparing procedure based on anatomy and embryology

Tarabay, Antonio; Maduri, Rodolfo; Rizzi, Mattia; Coll, J; Truttmann, Anita C.; Messerer, Mahmoud

doi:10.1007/s00381-020-04611-9

Cited by 1 publication

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References 24 publications

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“…However, surgical exposure is slightly restricted compared to traditional laminotomy, so the technique is well-suited for pathologies located in the posterior midline of the spinal canal. In fact, the technique is frequently used for one-level surgery (e.g., sectioning the filum terminale) [ 11 , 12 ], but its use in a long-segment approach remains anecdotal [ 13 , 14 ]. Furthermore, in some cases, midline splitting is not feasible or convenient because of anatomical differences between spinous processes and laminas [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Technical note–in situ laminotomy: preserving posterior tension band in surgery of pediatric multilevel spinal tumor

et al. 2023

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Background Laminotomy has been introduced in surgical practice to reduce complications of laminectomy after surgery of tumors in the spinal canal. However, the posterior ligament complex, which is routinely interrupted to remove the laminoplasty segment and gain access to the spinal canal, has a tendency not to heal and can lead to progressive kyphosis and collapse. Case presentation A 5-month-old boy affected by a thoracolumbar extradural tumor extending along seven spinal levels was operated on. The tumor was exposed and completely resected by a one-piece laminotomy with preservation of the integrity of the posterior tension band at both extremities. After 1-year radiological examination ruled out spinal deformity. Conclusion The technique herein presented, which we named in situ laminotomy, allows to fully preserve the posterior tension band without reducing the exposure of the spinal canal in multilevel tumors. Additionally, the technique makes also the reconstruction of the spine elements very easy and rapid. However, longer follow-up is necessary to prove the effectiveness of this procedure in preventing long-term deformity and instability.

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