Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Removal of Intradural-Extramedullary Spinal Cord Tumors with Unilateral Limited Laminectomy

  • Sim, Jong-Eun (Department of Neurosurgery College of Medicine Dong-A University) ;
  • Noh, Seung-Jin (Department of Neurosurgery College of Medicine Dong-A University) ;
  • Song, Young-Jin (Department of Neurosurgery College of Medicine Dong-A University) ;
  • Kim, Hyung-Dong (Department of Neurosurgery College of Medicine Dong-A University)
  • Published : 2008.05.31
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Abstract

Total laminectomy for the removal of intradural-extramedullary spinal cord tumors has been used widely, but postoperative complications often develop, such as kyphosis, spinal instability, and persistent back pain. In this study, we evaluated seven patients with intradural-extramedullary spinal cord tumors with respect to the value of unilateral limited laminectomy. Our cases included six schwannomas, and one meningioma. The cervical region was involved in four cases, the thoracolumbar region in two cases, and the lumbar region in one case. The rationale for choosing a unilateral approach is to preserve musculoligamentous attachments and posterior bony elements as much as possible. The patients were mobilized on the third postoperative day and preoperative neurological symptoms were recovered within a few weeks. We did not observe any complication relating to unilateral limited laminectomy and at follow-up evaluation (at 3 and 12 months postoperatively), none of the patients showed spinal deformity or spinal instability. We think that the unilateral limited laminectomy is a safe and efficient technique for the treatment of intradural-extramedullary spinal cord tumors. We suggest that this technique is one of the best treatments for these tumors.

Keywords

References

  1. Alexander E Jr : Post-laminectomy kyphosis in Wilkins RH, Rengachary SS(eds) : Neurosurgery. New York : McGraw-Hill, 1985, pp 2293-2297
  2. Bertalanffy H, Mitani S, Otani M, Ichikizaki K, Toya S : Usefullness of hemilaminectomy for microsurgical management of intraspinal lesions. Keio J Med 41 : 76-79, 1992 https://doi.org/10.2302/kjm.41.76
  3. Cervoni L, Celli P, Cantore G, Fortuna A : Intradural tumors of the cauda equina : a single institution review of clinical characteristics. Clin Neurol Neurosurg 97 : 8-12, 1995 https://doi.org/10.1016/0303-8467(94)00053-9
  4. Chiou SM, Eggert HR, Laborde G, Seeger W : Microsurgical unilateral approaches for spinal tumour surgery : eight years' experience in 256 primary operated patients. Acta Neurochir (Wien) 100 : 127-133, 1989 https://doi.org/10.1007/BF01403599
  5. Eggert HR, Scheremet R, Seeger W, Gaitzsch J : Unilateral microsurgical approaches to extramedullary spinal tumours. Operative technique and results. Acta Neurochir (Wien) 67 : 245-253, 1983 https://doi.org/10.1007/BF01401426
  6. Levy WJ, Latchaw J, Hahn JF, Sawhny B, Bay J, Dohn DF : Spinal neurofibromas : a report of 66 cases and a comparison with meningiomas. Neurosurgery 18 : 331-334, 1986 https://doi.org/10.1227/00006123-198603000-00013
  7. Masaryk TJ : Neoplastic disease of the spine. Radiol Clin North Am 29 : 829-845, 1991
  8. Oktem IS, Akdemir H, Kurtsoy A, Koc RK, Menku A, Tucer B : Hemilaminectomy for the removal of the spinal lesions. Spinal Cord 38 : 92-96, 2000 https://doi.org/10.1038/sj.sc.3100963
  9. Pompili A, Caroli F, Cattani F, Crecco M, Giovannetti M, Raus L, et al : Unilateral limited laminectomy as the approach of choice for the removal of thoracolumbar neurofibromas. Spine 29 : 1698-1702, 2004 https://doi.org/10.1097/01.BRS.0000132311.89236.C2
  10. Reimer R, Onofrio BM : Astrocytomas of the spinal cord in children and adolescents. J Neurosurg 63 : 669-675, 1985 https://doi.org/10.3171/jns.1985.63.5.0669
  11. Sarioglu AC, Hanci M, Bozkus H, Kaynar MY, Kafadar A : Unilateral hemilaminectomy for the removal of the spinal space-occupying lesions. Minim Invasive Neurosurg 40 : 74-77, 1997 https://doi.org/10.1055/s-2008-1053420
  12. Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O : Long-term outcome after removal of spinal schwannoma : a clinic-opathological study of 187 cases. J Neurosurg 83 : 621-626, 1995 https://doi.org/10.3171/jns.1995.83.4.0621
  13. Simeone FA : Spinal cord tumors in adults in Youmans JR (eds) : Neurological Surgery. Philadelphia : WB Saunders Company, 1990, pp 3531-3547
  14. Stein BM, McCormick PC : Intramedullary neoplasms and vascular malformations. Clin Neurosurg 39 : 361-387, 1992
  15. Tredway TL, Santiago P, Hrubes MR, Song JK, Christie SD, Fessler RG : Minimally invasive resection of intradural-extradullary spinal neoplasms. Neurosurgery 58 (1 suppl) : 52-58, 2006
  16. Yasargil MG, Tranmer BI, Adamson TE, Roth P : Unilateral partial hemi-laminectomy for the removal of extra- and intramedullary tumours and AVMs. Adv Tech Stand Neurosurg : 113-132, 1991
  17. Yasuoka S, Peterson HA, MacCarty CS : Incidence of spinal column deformity after multilevel laminectomy in children and adults. J Neurosurg 57 : 441-445, 1982 https://doi.org/10.3171/jns.1982.57.4.0441