|Cervical Hemilaminoplasty with Miniplates in Long Segment Intradural Extramedullary Ependymoma: Case report and Technical Note|
|Şükrü Oral1, Abdulfettah Tümtürk2, Ahmet Küçük2, Ahmet Menkü2|
|1Kayseri Eğitim ve Araştırma Hastanesi, NÖROŞİRÜRJİ, KAYSERİ,
2Erciyes Üniversitesi Tıp Fakültesi, NÖROŞİRÜRJİ, KAYSERİ,
AIM The surgical approaches for spinal tumors, to a great extent, have been developed in accordance with the developments in technology. Today, many surgical techniques are implemented as anterior, anterolateral, posterior, posterolateral and combined approach. Due to its low morbidity, posterior approach is more preferred one. Laminectomy is a widely used technique especially in neoplastic lesions. However, following laminectomy, there are complications like instability, kyphotic deformity and scar formation. In the current study, the excision of a tumor which was localized intradural-extramedullary at C3-C7 level with cervical hemi-laminoplasty technique is described. CASE A forty-seven year-old female patient was admitted to our clinic with increasing complaints of neck and left arm pain, left arm numbness and searing lasting for 10 years. In her examination, hypoesthesia in C4-7 dermatomes in left upper extremity, an increase in deep tendon reflexes and a bilateral Hoffmann positiveness were observed. METHOD With midline skin incision, C3-C7 laminas were opened unilaterally on the right side. Laminas were drilled with high-speed drill for wide-opening both on the midline obliquely and from the border of laminas-facet joint. After the tumor was totally excised, hemi-laminas were put into the previous position and reconstructed with mini-plates and screws. CONCLUSION Cervical hemi-laminoplasty provides a wide field of vision in the tumor surgery of this region. Besides, the reconstruction of hemi-laminas is important for stability. And, as the integrity of the spinal canal is preserved during reoperations implemented to this region, it will decrease the complication risk.
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