title: Unilateral Hemilaminectomy for Intradural Lesions.
abstract: OBJECTIVE
  Unilateral hemilaminectomy (UHIL), an alternative surgical approach to intradural lesions, involves a unilateral approach to meningeal opening that provides an adequate window for tumor extraction while leaving most of the vertebral structures intact. The techniques and results of a modified hemilaminectomy technique with spinal endoscopy is discussed and limited unilateral hemilaminectomy for intradural tumors (UHIT) evaluated prospectively.
  
  
  METHODS
  Relevant clinical variables, operative reports, histological findings, pre- and post-operative imaging, and follow-up data for 11 consecutive patients (five males, six females; mean age 63.36 ± 20.69 years) who underwent modified hemilaminectomy over a 3 year time period were analyzed. Contrast-enhanced MRI was used to demonstrate the side, size and location of the suspected tumor or intradural lesion and CT to evaluate the bone anatomy. Post-operative MRI and CT allowed evaluation of anatomy following resection.
  
  
  RESULTS
  Lesions included meningiomas (n = 2), neuromas (n = 3), and metastases, cysts or gliomas (n = 6). Pre-operative indications in order of incidence included cord compression, claudication, lower back pain, radiculopathy, paraplegia, weakness, incontinence, and generalized neuro-deterioration. There were no major complications, and no spinal deformity or instability at final follow up (mean, 13 months; range, 3-36 months).
  
  
  CONCLUSIONS
  Our data suggest that there is a place for the UHIT approach. This minimally invasive approach is useful for resecting all intradural tumors. UHIL is a useful minimally invasive technique for resecting intradural spinal tumors with maximal preservation of musculoligamentous attachments and posterior bony elements and should be considered an improvement on currently employed techniques.
authors: Neuro Spine Clinic, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors: Ralph J
authors: RJ
authors: Mobbs
authors: Neuro Spine Clinic, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
authors: Monish M
authors: MM
authors: Maharaj
authors: Neuro Spine Clinic, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
authors: Kevin
authors: K
authors: Phan
authors: Neuro Spine Clinic, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors: Prashanth J
authors: PJ
authors: Rao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Arachnoid cyst; Hemilaminectomy; Intradural tumor; Technique