Hemilaminectomy for the removal of the spinal lesions

Objective: We evaluated 20 patients with spinal lesions with respect to the value of unilateral hemilaminectomy at the Department of Neurosurgery, Erc iyes University, Medical Faculty, Kavseri, Turkey. The operative technique of the limited approach for spinal lesions is described. Methods: The study is based on 20 prospective consecutive patients with spi nal lesions who had unilateral hemilaminectomy. There were 12 women and eig ht men. Age ranged from 17 to 63 years mean (42 years) with a slight prepon derance of women patients (60%). Spinal lesions were cervical in three case s, lumbar in five cases, and thoracic in 12 cases. Hemilaminectomy was perf ormed by using a high speed drill. Results: Postoperative neurological status was unchanged in six cases, impr oved in 11 cases, and worsened in three cases. We only observed two cases o f wound infections that were not related to our surgical approach. At the f ollow-up evaluation, which occurred approximately 25 months after surgery n one of the patients showed spinal deformity or spinal instability. Conclusion: The rationale of attempting unilateral approach is to avoid dam age to the dorsal static structures of the vertebral column. With the preci se preoperative definition of the relationship of tumor to the surface of t he spinal cord by contrast enhanced MRI, unilateral approaches might be mor e applicable to spinal lesions except invasive extradural lesions.