Unilateral microsurgical approaches to extramedullary spinal tumours. Operative technique and results

The operative technique of limited approaches to extramedullary spinal tumours is described. The results after unilateral approaches are as satisfying as after standard laminectomies. The rationale of attempting an unilateral approach is to avoid damage to the dorsal static structures of the vertebral column. Access given by limited approach and possibilities of enlarging the bony defect depending on the topographical situation of the tumour are discussed in detail. It is emphasized that the dura should be opened only over the tumour in order to avoid protrusion of the cord.