• World Neurosurg · Sep 2024

    Does Minimally Invasive Hemilaminectomy for Intradural Extramedullary Tumor Resection Prevent Postlaminectomy Kyphosis or Lordosis Loss?

    • Federico Landriel, Jorge Rasmussen, Fernando Padilla Lichtenberger, Florencia Casto, Tomas Saavedra Azcona, Alfredo Guiroy, and Santiago Hem.
    • Department of Neurosurgery, Spine Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: federico.landriel@hospitalitaliano.org.ar.
    • World Neurosurg. 2024 Sep 1; 189: e718e724e718-e724.

    BackgroundMinimally invasive hemilaminectomy is a safe and effective alternative to open laminectomy for treating intradural extramedullary tumors. There are no reports of postoperative kyphosis after this approach. This study aims to determine whether performing minimally invasive spine surgery hemilaminectomy for intradural extramedullary tumors can prevent the development of postlaminectomy kyphosis (PLK) or lordosis loss.Material And MethodsSixty-five patients with spinal intradural extramedullary tumors who underwent minimally invasive hemilaminectomy surgery and complete pre and postoperative radiologic imaging were included. The effect of the surgical approach on the spinal sagittal axis was assessed by comparing pre- versus postoperative segmental and local Cobb angles at different spinal levels, considering anatomical localization (cervical, thoracic, lumbar, and transition segments) and functional features (mobile, semi-rigid, and transition segments), as well as the extent of the surgical approach (1, 2, or 3 levels) and follow-up.ResultsNone of the patients had an increase in thoracic kyphosis nor a loss of cervical or lumbar lordosis greater than or equal to 10° after undergoing the minimally invasive spine surgery hemilaminectomy approach. More than 5° of increase in kyphosis was detected on 7.4% and 11.1%, for the segmental and the local angles, respectively; meanwhile, for patients with loss of lordosis, this deviation was detected in 5.3%, for both angles. The occurrence of PLK was more common than that of lordosis loss, but mainly manifested in postoperative angle impairment of less than 5°. No significant differences were evidenced, considering the approach length.ConclusionsHemilaminectomy represents a promising approach for preventing PLK and postlaminectomy lordosis loss following intradural extramedullary tumor resection.Copyright © 2024 Elsevier Inc. All rights reserved.

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