| NI FEATURE: CENTS (CONCEPTS, ERGONOMICS, NUANCES, THERBLIGS, SHORTCOMINGS) - ORIGINAL ARTICLE
|Year : 2015 | Volume
| Issue : 2 | Page : 230--236
Unilateral hemilaminectomy: The surgical approach of choice for juxta-medullary spinal tumors
Sandeep Mohindra, Amey Savardekar
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Background: The conventional laminectomy may precipitate numerous long-term complications such as the development of kypho-scoliosis, spinal instability, epidural fibrosis and loss of bony shield over the spinal cord, thus increasing the risk of a subsequent myelopathy. The present study evaluates the efficacy of a unilateral hemilaminectomy as the surgical approach of choice for excision of juxtamedullary spinal neoplasms.
Materials and Methods: From January 2001 to December 2010, 83 patients (male: female ratio: 58: 25, mean age 37.4 years, median age 45 years) harboring a juxta-medullary spinal neoplasm were managed at our center. The radiological investigations included a contrast-enhanced magnetic resonance imaging (MRI) scan, (in the axial, sagittal and coronal planes). A high speed drill and an operating microscope assisted in the microsurgical excision of these neoplasms. During follow-up, MRI scans were obtained to check for any residual tumor.
Results: Complete tumor excision was achieved for all patients. At a mean follow-up of 17.6 months, the patients had improved to a better clinical status. The immediate postoperative complications in the form of paraparesis and cerebrospinal fluid leak were seen in 1 patient each, respectively; while none of the patients either developed post-operative spinal instability or required conversion of the hemilaminectomy to a conventional full laminectomy.
Conclusion: A unilateral hemilaminectomy is recommended as the microsurgical approach of choice for juxtamedullary spinal neoplasms.
Dr. Sandeep Mohindra
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh
Source of Support: None, Conflict of Interest: None
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