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Midline spinous process splitting laminoplasty in a newborn with thoracolumbar epidural hematoma: a bone-sparing procedure based on anatomy and embryology

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Abstract

Spinal epidural hematoma (SEH) is a rare condition leading to spinal cord compression after trauma, surgery, or other. In 40% of the cases, the cause is unknown or unidentified. Due to the absence of specific symptoms, the diagnosis is often delayed. The mainstay of treatment is urgent evacuation of the hematoma. The choice of the surgical technique is surgeon-dependent and ranges from simple decompression and hematoma evacuation to variable combinations of decompression and reconstruction of the posterior spinal arch. To our knowledge, we describe the youngest case in the literature of a thoracolumbar SEH in a newborn with hemophilia A which was evacuated by spinous process splitting laminoplasty (SPSL). SPSL was chosen to avoid damaging the primary ossification centers, preserve the paravertebral musculature, and evade the sequelae of multilevel laminectomies. In our opinion, this technique should be propagated in the pediatric population for accessing the posterior and posterolateral spinal canal.

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Authors and Affiliations

  1. Service of Neurosurgery, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Antonio Tarabay, Rodolfo Maduri & Mahmoud Messerer

  2. Department of Woman-Mother-Child, Division of Pediatrics, Hematology/Oncology Unit, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Mattia Rizzi

  3. Spine unit, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Juan Barges-Coll & Mahmoud Messerer

  4. Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre Decker, 1011, Lausanne, Switzerland

    Anita C. Truttmann

Authors
  1. Antonio Tarabay
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  2. Rodolfo Maduri
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  3. Mattia Rizzi
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  4. Juan Barges-Coll
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  5. Anita C. Truttmann
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  6. Mahmoud Messerer
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Correspondence to Mahmoud Messerer.

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Informed consent was obtained from the parents of the infant presented in this report.

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Tarabay, A., Maduri, R., Rizzi, M. et al. Midline spinous process splitting laminoplasty in a newborn with thoracolumbar epidural hematoma: a bone-sparing procedure based on anatomy and embryology. Childs Nerv Syst 36, 3103–3108 (2020). https://doi.org/10.1007/s00381-020-04611-9

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  • DOI: https://doi.org/10.1007/s00381-020-04611-9

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