title: Hemilaminectomy for spinal meningioma: A case series of 20 patients with a focus on ventral- and ventrolateral lesions.
abstract: OBJECTIVE
  To demonstrate the effectiveness and safety of hemilaminectomy in spinal-meningioma surgery, with special attention to ventral lesions. We also describe technical tips to enhance surgical-corridor width.
  
  
  METHODS
  A total of 20 patients (14 female and 6 male) underwent hemilaminectomy for resection of a spinal meningioma between January 2005 and December 2015. Preoperative magnetic resonance imaging defined the tumor location (16 thoracic, 3 cervical, 1 lumbar) and the dural-attachment site (4 ventral, 11 ventrolateral, 3 lateral, 2 posterior). Pre- and postprocedural functional status was evaluated according to McCormick's classification. Intraoperative neurophysiological monitoring was employed in all patients.
  
  
  RESULTS
  The unilateral approach allowed for complete resection (Simpson grade I-II resection) in 18 patients (90%), including tumors with a ventral dural attachment. In most patients (n=13), monosegmental hemilaminectomy was performed, a single patient required hemilaminectomy of 3 levels, while the remaining 6 patients underwent hemilaminectomy of 2 levels. No patients experienced either worsening of neurological status or procedure-related complications. All patients who had preoperative pain reported postoperative improvement.
  
  
  CONCLUSIONS
  The goal of surgery for spinal tumors is to achieve gross tumor removal while minimizing morbidity. In our experience, hemilaminectomy is an effective surgical approach, even in patients with ventral- and ventrolateral spinal meningiomas. The procedure offers several advantages in terms of early patient mobilization and rehabilitation, management of postoperative pain, and preservation of spinal stability while achieving positive functional outcomes.
authors.affiliation: Department of Neurology and Psychiatry, University of Rome "Sapienza", Rome, Italy; Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Tola
authors.affiliation: Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy; Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, School of Medicine and Surgery "Federico II", Naples, Italy. Electronic address: michelangelo.dea@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: De Angelis
authors.affiliation: Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bistazzoni
authors.affiliation: Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Chiaramonte
authors.affiliation: Department of Neurology and Psychiatry, University of Rome "Sapienza", Rome, Italy; Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Esposito
authors.affiliation: Department of Neurosurgery, IRCCS Neuromed, Pozzilli, Italy; Department of Science and Medical Biotecnology, University of Rome "Sapienza", Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Paolini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hemilaminectomy; Meningioma; Posterior approaches; Spinal meningioma; Unilateral; Ventrolateral