Technical note–in situ laminotomy: preserving posterior tension band in surgery of pediatric multilevel spinal tumor

Background Laminotomy has been introduced in surgical practice to reduce complications of laminectomy after surgery of tumors in the spinal canal. However, the posterior ligament complex, which is routinely interrupted to remove the laminoplasty segment and gain access to the spinal canal, has a ten...

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Veröffentlicht in:Child's nervous system 2023-06, Vol.39 (6), p.1641-1646
Hauptverfasser: Frassanito, Paolo, Noya, Carolina, Ducoli, Giorgio, Massimi, Luca, Bianchi, Federico, Verdolotti, Tommaso, Tamburrini, Gianpiero
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container_end_page 1646
container_issue 6
container_start_page 1641
container_title Child's nervous system
container_volume 39
creator Frassanito, Paolo
Noya, Carolina
Ducoli, Giorgio
Massimi, Luca
Bianchi, Federico
Verdolotti, Tommaso
Tamburrini, Gianpiero
description Background Laminotomy has been introduced in surgical practice to reduce complications of laminectomy after surgery of tumors in the spinal canal. However, the posterior ligament complex, which is routinely interrupted to remove the laminoplasty segment and gain access to the spinal canal, has a tendency not to heal and can lead to progressive kyphosis and collapse. Case presentation A 5-month-old boy affected by a thoracolumbar extradural tumor extending along seven spinal levels was operated on. The tumor was exposed and completely resected by a one-piece laminotomy with preservation of the integrity of the posterior tension band at both extremities. After 1-year radiological examination ruled out spinal deformity. Conclusion The technique herein presented, which we named in situ laminotomy, allows to fully preserve the posterior tension band without reducing the exposure of the spinal canal in multilevel tumors. Additionally, the technique makes also the reconstruction of the spine elements very easy and rapid. However, longer follow-up is necessary to prove the effectiveness of this procedure in preventing long-term deformity and instability.
doi_str_mv 10.1007/s00381-023-05863-x
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subjects Case Report
Child
Humans
Infant
Laminectomy - methods
Male
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Spinal Canal - surgery
Spinal Cord Neoplasms - complications
Spinal Cord Neoplasms - diagnostic imaging
Spinal Cord Neoplasms - surgery
Spinal Neoplasms - complications
Spinal Neoplasms - diagnostic imaging
Spinal Neoplasms - surgery
Spine - surgery
title Technical note–in situ laminotomy: preserving posterior tension band in surgery of pediatric multilevel spinal tumor
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