Abstract
In view of the hazards of extensive laminectomy in children, an osteoplastic laminectomy was used in an eight-year-old child suffering from an intramedullary astrocytoma extending from C4 to C7. The laminae were first of all divided bilaterally about 2 mm medial to their origin, with a fine spherical cutter. After dividing the ligamenta flava and the interspinous ligaments the dorsal wall of the spinal canal from C4 to C7 was removed en bloc. The dura was opened and the spinal cord split in the midline after which the microsurgical excision of a spindle-shaped cystic astrocytoma was carried out. After closing the dura drill holes were made bilaterally in the stumps of the pedicles and in the ends of the resected laminae. The entire piece, consisting of laminae and ligaments was replaced and fixed to the stumps of the pedicles with four pairs of wire sutures. Included in the sutures was a small block of bone measuring 2 x 3 x 5 mm, which replaced the bone lost in the saw-cuts and thus prevented any narrowing of the spinal canal. The ligaments were sutured and the wound closed in layers, with drainage. Immobilization in a Minerva plaster for three months.
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