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Updated: Aug 5, 2026
Percutaneous Endoscopic Unilateral-Approach Bilateral Decompression for Lumbar Spinal Stenosis
Published on: February 9, 2024
Unilateral hemilaminectomy for pediatric intradural spinal tumors: a consecutive case series
Serdar Kahraman1,2, Mehmet Alpay Çal3
1Department of Neurosurgery, Faculty of Medicine, İstinye University, Ayazağa Mah. Azerbaycan Cad. (Vadistanbul 4 A) Blok No: 3H, PK: 34396, Sarıyer, Istanbul, Turkey. serkah@hotmail.com.
Purpose:
To describe the perioperative, oncologic, and structural outcomes of unilateral hemilaminectomy for pediatric intradural spinal tumors.
Methods:
We retrospectively reviewed all children aged ≤ 16 years who underwent unilateral hemilaminectomy for an intradural spinal tumor at a single tertiary center between 2018 and 2023. Clinical records, operative data, early postoperative contrast-enhanced MRI, and subsequent surveillance imaging were evaluated. Primary outcomes were 30-day complications and clinically detected postoperative deformity or instability requiring further evaluation or treatment.
Results:
Among 246 spinal tumor operations across all age groups, 11 involved children; six extradural tumors were excluded, and all five pediatric intradural tumors underwent unilateral hemilaminectomy. Four patients were aged 13-16 years. Early postoperative MRI demonstrated gross-total resection in three patients, near-total resection in one, and subtotal resection in one. In the latter patient, a greater than 80% reduction in motor-evoked potential amplitude prompted termination of the index procedure without tumor resection. An unplanned second operation was performed 7 days later, but similar monitoring deterioration limited resection to subtotal removal. The child experienced transient quadriparesis after both procedures; both episodes resolved before discharge. Stereotactic radiotherapy was subsequently administered. During a median follow-up of 26 months (range, 18-84 months), no tumor-related reoperation or clinically detected deformity or instability requiring bracing, referral, or fusion was documented.
Conclusion:
Unilateral hemilaminectomy provided surgical access for pediatric intradural tumors while preserving the contralateral posterior elements. However, the small, predominantly adolescent cohort, absence of systematic standing radiographs, and limited follow-up preclude conclusions regarding subtle or late deformity or comparative superiority.
