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Acta Neurochirurgica

, Volume 157, Issue 10, pp 1813–1817 | Cite as

Bilateral spinal canal decompression via hemilaminectomy in cervical spondylotic myelopathy

  • Dorothee MielkeEmail author
  • Veit Rohde
How I Do it - Spine

Abstract

Background

In cervical spondylotic myelopathy (CSM), laminoplasty (LP) or laminectomy plus fusion (LF) are accepted operative options and alternatives to anterior approaches. Both LP and LF have distinctive disadvantages, which might be avoided by unilateral hemilaminectomy and bilateral decompression of the spinal cord.

Methods

Description of the surgical technique, indications, and limitations. The potential advantages in comparison to LP and LF are discussed.

Conclusions

Unilateral hemilaminectomy allows bilateral decompression of the whole dorsal circumference of spinal cord from nerve root to nerve root. The potential major advantages are a reduction of invasiveness by only unilateral muscle detachment, avoidance of implants, and shorter operation times.

Keywords

Cervical spine Cervical spondylotic myelopathy Spinal canal stenosis Decompression Hemilaminectomy Bilateral decompression 

Notes

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Supplementary material

701_2015_2549_MOESM1_ESM.mp4
ESM 1 The approach in this case is from the right side. After muscle detachment from the hemilaminae, primarily a hemilaminectomy is performed. Care is taken to preserve the integrity of the facet joint. The next step is removal of the base of the spinous process(es) with the drill and Kerrison rongeur, beginning at the medial edge of the hemilaminectomy and ending near the contralateral medial part of the facet joint(s), thereby thinning the inner contralateral hemilaminae. The hypertrophied ligament is further being removed. Bleeding from the epidural veins can easily be managed by coagulation and GELFOAM (MP4 87643 kb)

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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  1. 1.Department of NeurosurgeryGeorg-August-University GöttingenGöttingenGermany
  2. 2.Klinik und Poliklinik für NeurochirurgieGeorg-August-Universität GöttingenGöttingenGermany

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