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Limited exposure to preserve stability and achieve complete excision of limited dorsal myeloschisis — the “Skip-Hop Laminectomy” technique: a technical note

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Abstract

Objective

The fibroneural stalk of an LDM has variable thickness, complexity, and length, which can span 5 to 6 vertebral segments from its skin attachment to its “merge point” with the dorsal spinal cord. Therefore, complete resection may require extensive multi-level laminotomies. In this technical note, a modification of the procedure is presented that avoids long segment laminectomies while ensuring complete excision of long LDM stalks.

Results

An illustrative case of resection of LDM is presented using skip laminectomies. The technique ensures complete removal of the stalk, thus reducing the risk of future intradural dermoid development, while at the same time minimizes the risk for delayed kyphotic deformity.

Conclusions

A technique of “skip-hop” proximal and distal short segment laminectomies in cases of LDM optimizes the objectives of complete stalk resection with preservation of spinal integrity.

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References

  1. Pang D, Zovickian J, Oviedo A, Moes GS (2010) Limited dorsal myeloschisis: a distinctive clinicopathological entity. Neurosurgery 67(6):1555–1579; discussion 1579–1580. https://doi.org/10.1227/NEU.0b013e3181f93e5a

  2. Pang D, Zovickian J, Wong ST, Hou YJ, Moes GS (2013) Limited dorsal myeloschisis: a not-so-rare form of primary neurulation defect. Childs Nerv Syst 29(9):1459–1484. https://doi.org/10.1007/s00381-013-2189-2

    Article  PubMed  Google Scholar 

  3. Wong ST, Pang D (2021) Focal spinal nondisjunction in primary neurulation : limited dorsal myeloschisis and congenital spinal dermal sinus tract. J Korean Neurosurg Soc 64(2):151–188. https://doi.org/10.3340/jkns.2020.0117

    Article  PubMed  PubMed Central  Google Scholar 

  4. Eibach S, Moes G, Zovickian J, Pang D (2017) Limited dorsal myeloschisis associated with dermoid elements. Childs Nerv Syst 33(1):55–67. https://doi.org/10.1007/s00381-016-3207-y

    Article  PubMed  Google Scholar 

  5. Lee JY, Chong S, Choi YH et al (2017) Modification of surgical procedure for “probable” limited dorsal myeloschisis. J Neurosurg Pediatr 19(5):616–619. https://doi.org/10.3171/2016.12.PEDS16171

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Great Ormond Street Hospital for Children, London, England

    Michelle Kameda-Smith, M Zubair Tahir, Dominic Thompson & Dachling Pang

  2. Department of Paediatric Neurosurgery, London, England

    Michelle Kameda-Smith, M Zubair Tahir, Dominic Thompson & Dachling Pang

  3. Department of Histopathology, London, England

    Atul Kumar

Authors
  1. Michelle Kameda-Smith
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  2. M Zubair Tahir
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  3. Atul Kumar
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  4. Dominic Thompson
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  5. Dachling Pang
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Contributions

ZT and DP conceived the project, and MK and DP wrote the manuscript with critical revisions by DT. AK provided histopathological images and revised the histology section of the manuscript. ZT and DP supervised the project. All authors reviewed the final submitted manuscript.

Corresponding author

Correspondence to Dachling Pang.

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The authors have no financial and non-financial competing interests.

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Kameda-Smith, M., Tahir, M., Kumar, A. et al. Limited exposure to preserve stability and achieve complete excision of limited dorsal myeloschisis — the “Skip-Hop Laminectomy” technique: a technical note. Childs Nerv Syst 40, 213–218 (2024). https://doi.org/10.1007/s00381-023-06069-x

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  • DOI: https://doi.org/10.1007/s00381-023-06069-x

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