Usefulness of Hemilaminectomy for Microsurgical Management of Intraspinal Lesions

Hemilaminectomy is a limited, unilateral approach to the spinal cordthat provides excellent exposure of the dorsolateral and ventral portions of thespinal canal. This approach is most suitable for microsurgical management of themajority of extramedullary tumors. Contrary to conventional laminec-tomy, the posterior supporting structures of the spine are completely preserved on the contralateral side with this access route. The procedure has been applied in 3 patients who harbored a cervical neurilemmoma, a cervical lipoma, and a thoracic neurilemmoma, respectively. Optimal exposure of the lesion was achieved in each case, and each patient's symptoms improved or completely resolved postoperatively. There were no surgical complications. It is concluded that hemilaminectomy combinedwith microsurgical techniques should be given priority over standard laminectomyin the surgical management of extramedullary lesions arising in the spinal canal.