title: Unilateral multilevel interlaminar fenestration: a minimally invasive approach for cervical intramedullary lesions.
abstract: The traditional approach for cervical intramedullary lesions is laminectomy, but the procedure may result in spinal instability and spinal deformity. Unilateral multilevel interlaminar fenestration (UMIF) is an alternative minimally invasive approach that may have great advantages in preserving spinal stability. However its use in cervical intramedullary lesions is rare, and the indications, safety and limitations of this approach for cervical intramedullary lesions are still under investigation. We report five patients (three males, two females, age range 12-46 years) who were treated between 2010 and 2011 for cervical intramedullary lesions. The lesions included three ependymomas, one astrocytoma and one ependymal cyst, and the locations of the lesions were at the medulla-T2, C4-T1, C5-C7, C4-C7 and C6-C7. All of these lesions were completely removed through UMIF, and all patients had stable or improved neurological status after surgery. No recurrences or spinal deformities were detected during the follow-up period which ranged from 24 to 35 months (mean=27.4 months). UMIF is a feasible approach for selected cervical intramedullary lesions. This approach allows complete resection of multilevel lesions without increasing the risk of injury to the spinal cord, and minimizing the risk of postoperative spinal instability. The indications for and limitations of UMIF are discussed.
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China.
authors.forename: Tianhao
authors.initials: T
authors.lastname: Xie
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qian
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China.
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China.
authors.forename: Yikun
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China.
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Wan
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, No. 415 FengYang Road, Shanghai 200003, China. Electronic address: chunluocznwk@163.com.
authors.forename: Chun
authors.initials: C
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cervical intramedullary lesions; Hemilaminectomy; Laminectomy; Minimally invasive; Unilateral multilevel interlaminar fenestration