Unilateral partial hemilaminectomy in the removal of a large spinal ependymoma

Abstract

Background context Although the hemilaminectomy technique is known to neurosurgeons performing spinal surgery, laminectomy traditionally has been used during spinal canal surgery for extirpation of spinal cord tumors. Purpose Although the technique of unilateral partial hemilaminectomy is familiar in its various permutations to surgeons, its application in the spinal tumor surgery has been rarely reported. The aim of this study was to review the literature about the management of spinal cord ependymomas and to discuss the major controversies in treatment. Study design Case report. Patient sample A 52-year-old man. Methods The 52-year-old man complained of backache and leg pain bilaterally, dominant on the left side. Spinal magnetic resonance images revealed an intradural mass at the T12–L2 level. A left unilateral hemilaminectomy of the T12–L1 and L2 was performed with the help of high-speed air drills under microscopic magnification and a midline incision was made on the dura. The tumor was totally removed. Results By using microsurgical techniques and with the help of high-speed drills, a unilateral approach to the intramedullary tumors proved itself to be a safe and easy method in this case. It protected the posterior supporting elements and also permitted the surgeon to manipulate the intradural contralateral side easily. The only difficulty during the operation was the suturing of the dural sac. Conclusions This case report emphasizes the need to consider the hemilaminectomy technique in spinal tumor surgery.