• Alessandro Di Rienzo, Denise Brunozzi, Mauro Dobran, Maurizio Iacoangeli, Roberto Colasanti, Rikin Trivedi, and Massimo Scerrati.
• Department of Neurosurgery, Università Politecnica delle Marche, Ancona, Italy.
• World Neurosurg. 2018 Mar 1; 111: e933-e940.

ObjectiveWe present our experience with a modification of the conventional techniques for the removal of large spinal epidural hematomas (SEHs), based on multilevel "skip hemilaminectomies."MethodsEleven patients with SEHs extending over 5 or more spinal segments were treated at our institution via a modified hemilaminectomy technique from 2008 to 2014. This procedure, that we called "skip hemilaminectomy," consists in performing consecutive, alternating, unilateral laminar decompressions at 2-3 levels, followed by sublaminar undercutting, ipsi- and contralateral flavectomy, plus hematoma removal.ResultsComplete clot evacuation and full neurologic recovery were always achieved. A short hospital stay, fast postoperative mobilization, a minimized need of analgesic drugs, and no complications were recorded.ConclusionsIn our preliminary experience, skip hemilaminectomy seems to be as safe as more conventional techniques (laminectomy, extended hemilaminectomy) for the removal of large multilevel SEHs, granting full neurologic improvement, short surgical times-even for very large lesions-and no complications at follow-up.Copyright © 2018 Elsevier Inc. All rights reserved.

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