title: Unilateral hemilaminectomy: The surgical approach of choice for juxta-medullary spinal tumors.
abstract: BACKGROUND
  The conventional laminectomy may precipitate numerous long-term complications such as the development of kypho-scoliosis, spinal instability, epidural fibrosis and loss of bony shield over the spinal cord, thus increasing the risk of a subsequent myelopathy. The present study evaluates the efficacy of a unilateral hemilaminectomy as the surgical approach of choice for excision of juxtamedullary spinal neoplasms.
  
  
  METHODS
  From January 2001 to December 2010, 83 patients (male: female ratio: 58: 25, mean age 37.4 years, median age 45 years) harboring a juxta-medullary spinal neoplasm were managed at our center. The radiological investigations included a contrast-enhanced magnetic resonance imaging (MRI) scan, (in the axial, sagittal and coronal planes). A high speed drill and an operating microscope assisted in the microsurgical excision of these neoplasms. During follow-up, MRI scans were obtained to check for any residual tumor.
  
  
  RESULTS
  Complete tumor excision was achieved for all patients. At a mean follow-up of 17.6 months, the patients had improved to a better clinical status. The immediate postoperative complications in the form of paraparesis and cerebrospinal fluid leak were seen in 1 patient each, respectively; while none of the patients either developed post-operative spinal instability or required conversion of the hemilaminectomy to a conventional full laminectomy.
  
  
  CONCLUSIONS
  A unilateral hemilaminectomy is recommended as the microsurgical approach of choice for juxtamedullary spinal neoplasms.
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mohindra
authors.forename: Amey
authors.initials: A
authors.lastname: Savardekar