| CASE REPORT |
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| Year : 2014 | Volume
: 1
| Issue : 2 | Page : 84-90 |
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Microsurgical management of intraspinal tumors in the lumbar spine: Hemilaminectomy as an alternative to laminectomy
Don Mathew1, Tinu Ravi Abraham2, Ajith R Nair3
1 Non PG Registrar, Department of Neurosurgery, TD Medical college, Alappuzha, Kerala, India
2 Assistant Professor, Department of Neurosurgery, TD Medical college, Alappuzha, Kerala, India
3 Associate Professor, Department of Neurosurgery, TD Medical college, Alappuzha, Kerala, India
Correspondence Address:
Ajith R Nair
Senior consultant and Head, Department of Neurosurgery, SUT hospital, Pattom, Triruvananthapuram, Kerala
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.5005/jp-journals-10039-1017
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Introduction: Laminectomy is the classical surgical technique done for exposure of the spinal cord in the removal of intraspinal lesions. Here, we report a case where multilevel hemilaminectomy has been done to remove a long segment intraspinal tumor extending from D11 to L5.
Case report: A 47-year-old lady who had backache for 5 years, difficulty in walking for 6 month. She came to us with paraplegia (grade 0 power of both lower limbs), decreased sensation of both lower limbs and bladder incontinence. MRI revealed an intradural mass lesion extending from D11 to L5 level. multilevel hemilaminectomy was performed from D11 to L5 and near total resection of the tumor was done. Postoperatively, patient showed improvement with grade 1-2 power in lower limbs at the end of 3 months.
Advantages of hemilaminectomy: The main advantage of hemilaminectomy is the complete preservation of dorsal static structure of the vertebral column; such as the spinous process, the interspinous and supraspinous ligaments, and the unilateral preservation of the intervertebral joints, laminae, ligamentum flavae and the paraspinal muscles.
Conclusion: It is without doubt that patient morbidity and spine stability is better when surgery is performed through a narrow corridor. It can be concluded that hemilaminectomy is a safe and better alternative to laminectomy in the removal of long segment intradural tumors.
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