Laminectomy versus Unilateral Hemilaminectomy for the Removal of Intraspinal Schwannoma: Experience of a Single Institution and Review of Literature

• Published in: Journal of neurological surgery. Part A, Central European neurosurgery Vol. 82; no. 6; pp. 552 - 555
• Main Authors: Dobran, Mauro, Paracino, Riccardo, Nasi, Davide, Aiudi, Denis, Capece, Mara, Carrassi, Erika, Lattanzi, Simona, Rienzo, Alessandro DI, Iacoangeli, Maurizio
• Format: Journal Article
• Language: English
• Published: Rüdigerstraße 14, 70469 Stuttgart, Germany Georg Thieme Verlag KG 01.11.2021
• Subjects: Original Article; hemilaminectomy; spinal intradural extramedullary tumors; Spinal schwannomas; spinal minimally invasive approaches; laminectomy
• ISSN: 2193-6315; 2193-6323
• DOI: 10.1055/s-0041-1722968

Abstract Background and Study Aims  Spinal schwannomas are benign slow-growing tumors, and gross total resection is the gold standard of treatment. The conventional surgical approach is laminectomy, which provides a wide working area. Today minimally invasive surgery (MIS) is popular because it is associated with shorter hospital stay, less operative blood loss, minimized tissue traumas and relative postoperative pain, and, and spine surgery, avoidance of spinal instability. Material and Methods  From January 2016 to December 2019, we operated on 40 patients with spinal intradural extramedullary tumor (schwannoma) with laminectomy or hemilaminectomy. Baseline medical data, including patients' sex and age, tumor location, days of postoperative bed rest, operative time, length of hospitalization, and 1-month visual analog scale (VAS) value were collected and analyzed. Data analysis was performed using STATA/IC 13.1 statistical package (StataCorp LP, College Station, Texas, United States). Results  Hemilaminectomy was associated with faster operative time ( p  < 0.001), shorter postoperative time spent in bed ( p  < 0.001), and shorter hospitalization ( p  < 0.001). At 1-month follow-up, the mean VAS score was 4.6 (1.7) among the laminectomy patients and 2.5 (1.3) among the hemilaminectomy patients ( p  < 0.001). Postoperative complications occurred in 1 (7.7%) and 7 (25.9%) patients in the hemilaminectomy and laminectomy groups, respectively ( p  = 0.177). Conclusions  Unilateral hemilaminectomy has significant advantages compared with laminectomy in spinal schwannoma surgery including shorter operative time, less time spent in bed, shorter hospitalization, and less postoperative pain.