Unilateral Partial Hemilaminectomy for the Removal of Extra- and Intramedullary Tumours and AVMs

Yaşargil, M. Gazi; Tranmer, Bruce I.; Adamson, Tim E.; Roth, Patrick

doi:10.1007/978-3-7091-6697-0_3

Cited by 100 publications

(69 citation statements)

References 17 publications

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“…21 ± 23 Musculoligamentous insu ciency related to surgical stripping and denervation of the posterior paraspinal muscle complex has been suggested to be responsible for these progressive post-laminectomy problems. 24,25 Yasuoka et al 2 proposed that the visco-elasticity of the remaining ligaments after laminectomy might be another cause for postoperative spinal deformities. In addition to the age at operation, the site of laminectomy is also an important factor.…”

Section: Discussionmentioning

confidence: 99%

“…In an e ort to rate post-laminectomy deformity, a number of di erent operative approaches have been proposed. 3,15,24,25 Inoue et al 26 reported that the mechanism of spinal deformity after surgical removal of a cervical spinal cord tumor or tumorous lesions was studied in 36 patients, in which they compared laminectomy and laminoplasty groups. In the laminectomy group, kyphosis of the upper cervical spine and compensatory increased lordosis of the lower cervical spine were observed in the C2 laminectomy patients.…”

Section: Discussionmentioning

confidence: 99%

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Hemilaminectomy for the removal of the spinal lesions

et al. 2000

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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

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemilaminectomy for the removal of the spinal lesions

et al. 2000

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“…In literature to reduce the surgical trauma to the spinal column and allow the complete removal of intraspinally located space-occupying lesions at the same time, various less invasive surgical techniques are described [9,18,20,25,37,44,49].…”

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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“…7,11,12) Spinal instability after mul tilevel laminectomy is well documented in children. Yasuoka et al 19) reported a 46% incidence of spi nal deformity following multilevel laminectomy in children, and a 6% incidence in patients aged [15][16][17][18][19][20][21][22][23][24] years. Ya §argil et al") considered that lesions could be removed from the dorsal, dorsolateral, lateral, contralateral ventral, and dorsal aspects of the spinal cord using a posterolateral approach via unilateral hemilaminectomy.…”

Section: Discussionmentioning

confidence: 99%

Cervical Ventral Epithelial Cyst Treated by Anterior Corpectomy —Case Report—

Fujimoto

Kawai

Tanaka

et al. 1996

Neurol. Med. Chir.(Tokyo)

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A 15-year-old boy presented with a cervical ventral epithelial cyst manifesting as intractable cervical pain. Neurological examination revealed weakness of his left grasp and increased deep tendon reflexes. The anterior approach was selected because the lesion was located directly ventral to the spinal cord. He underwent C4-5 anterior corpectomy and subtotal resection of the cyst wall. He made a good recov ery without additional deficits. Most previously reported cases have been treated using the posterior ap proach despite the ventral location of the lesion. The anterior approach offers a safer and more effec tive means of treating such lesions because it allows direct access to the lesion without manipulation of the spinal cord.

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Unilateral Partial Hemilaminectomy for the Removal of Extra- and Intramedullary Tumours and AVMs

Cited by 100 publications

References 17 publications

Hemilaminectomy for the removal of the spinal lesions

Hemilaminectomy for the removal of the spinal lesions

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

Cervical Ventral Epithelial Cyst Treated by Anterior Corpectomy —Case Report—

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