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 NI FEATURE: CENTS (CONCEPTS, ERGONOMICS, NUANCES, THERBLIGS, SHORTCOMINGS) - ORIGINAL ARTICLE
Year : 2015  |  Volume : 63  |  Issue : 2  |  Page : 230--236

Unilateral hemilaminectomy: The surgical approach of choice for juxta-medullary spinal tumors


Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dr. Sandeep Mohindra
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.156289

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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.






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