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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Laminectomy is a procedure necessary to gain surgical access to the spinal canal. Whether just one lamina is removed or both lamina and the spinous process are to be excised depends on the location and nature of the spinous pathology (Figure 10.69). Spinal tumor removal or correction of spinal stenosis generally require a bilateral laminectomy. Decompression of a herniated disk pressing on a nerve root may require only a unilateral procedure. Whichever operation is performed, the bone is not replaced afterward, leaving a “window” of thermal conduction from the circulating cerebrospinal fluid to the skin above. This postoperative increased warmth over the spine will appear in the midline in the case of bilateral laminectomy, and just lateral to the midline when a unilateral laminectomy has been performed (Figure 10.70).
Lumbar Stenosis
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
The major risks of laminectomy and microdiscectomy include dural tear (1%), recurrent disc prolapse, and discitis (1%). There is also a risk of secondary instability if too much of the facet joint (generally thought to be about 50%) is removed during the laminectomy.
How to dissect the plane between the scar of a laminectomy defect in the posterior cervical spine
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Revision cervical laminectomy is associated with increased risk for intraoperative and postoperative complications compared to primary surgery. Distorted anatomy, as well as the presence of scarring, increase the risk for dural tear and neurologic injury, and revision surgery places the patient at higher risk for postoperative surgical site infection. Durotomy is most likely to occur during removal of scarring from the dura. As previously mentioned, it is important to identify areas of adhesion, as well as areas of dural thinning, as these areas predisposed to durotomy. If a dural tear does occur, it should be fixed primarily with 5-0 or 6-0 suture, and the repair may be supplemented with fibrin glue or a patch if needed. Patients should remain with the head of their bed elevated for at least 24 hours following a dural repair to facilitate closure and prevent formation of a pseudomeningocele.
Biomechanical effect of posterior ligament repair in lamina repair surgery
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Kaixiang Jin, Yuanjun Zhu, Nan Li, Yinghui Li, Yan Yao, Zhongjun Mo, Yubo Fan
Spinal tumours including primary and secondary tumours occurs in various tissues such as nerve root, blood vessel, spinal cord, and so on. There was about 9.7 patient with spinal tumour in every one million (Duetzmann et al. 2015). Cervical laminectomy has usually been applied in treating cervical spinal cord tumour (Hirabayashi et al. 1983). However, the incidence rate of spinal instability following laminectomy was reportedly 20% in adults (Katsumi et al. 1989) and up to 45% in children (Yeh et al. 2001), since the posterior structures, including interspinous ligament, supraspinous ligament, flaval ligament and spinous process, was excised in laminectomy (Haddadi and Ganjeh Qazvini 2016). Excision of posterior structures increased the range of motion of anterior vertebrae, which induced declination and torsion of vertebrae, resulting in spinal instability (Kotani et al. 1994; McGirt et al. 2010; Wang et al. 2021). The previous studies reported the increase in ROM in laminectomies, which was likely to result in developing spinal kyphosis or other deformity (Goel et al. 1988; Saito et al. 1991; Hong-Wan et al. 2004; Ogden et al. 2009; Tadepalli et al. 2011; Xie et al. 2013; Ahmed et al. 2014; Kode et al. 2014). Spinal deformity following laminectomy would compress spinal cord or nerve root, subsequently result neurological symptoms as back pain and radiculopathy.
Pathogenesis, management strategies, and outcome of non-communicating extradural spinal arachnoid cyst (NEAC): a systematic review
Published in British Journal of Neurosurgery, 2023
Mohammad Shahidul Islam Khan, Nazmin Ahmed, Kanak Kanti Barua, Bipin Chaurasia, Atul Vats, Atul Goel
A total 21 patients reported through 13 publications related to NEAC (Table 1). The mean age of the cases was 27.18 years (range: 20 months − 51 years). Among those cases, 11 were male and 10 were female. Based on neuroimaging findings, cysts were most commonly found at dorsal (10 patients) and dorsolumbar region (9 patients). Congenital predisposition was the most common proposed aetiology (19 patients) followed by traumatic and back surgery. All of the cases have presentation with paraparesis with variable degree of sensory disturbance. Among those, loss of position and vibration sense was most common, associated anomalies were seen in three patients. During surgery, 12 patients underwent laminectomy whereas only one patient underwent additional fusion procedure. Two patients were treated with laminoplasty (either T saw laminoplasty or vascularized pedicled laminoplasty) and for others, management procedure was not mentioned.
Treatment of Thoracic Ossification of Posterior Longitudinal Ligament with One-Stage 360 Degree Circumferential Decompression Assisted by Piezosurgery
Published in Journal of Investigative Surgery, 2022
Peng Yang, Rile Ge, Zhong-qiang Chen, Bing-tao Wen
The clinical relevance of the current study related to the surgical details of OPLL block resection with piezosurgery technique. During a laminectomy, reduction in the spinal cord interference should be performed when the ossification block was separated and removed. This method ensured that the lateral intervertebral space could be widened before facilitating the operation. The ossification block then floated completely and was removed with less spinal cord interference. There were some cases with adhesions between the ossification block and the dura mater. To address such cases, the ossification mass without adhesions was treated first, before proceeding to the more difficult part. If necessary, the dura mater with partial adhesion or ossification can be removed. Based on the findings and limitations of piezosurgery technique, we propose that surgeons should be careful when operating the ultrasonic knife head because of its likelihood to break during the bone cutting process. In complicated cases of OPLL resection, it is also preferable to use the hook, spoon or rake knife heads to grind and divide the OPLL. Moreover, in order to mitigate the thermogenic effect, the ultrasonic knife head must remain parallel to the cutting cross-section, but the knife head should not be kept in the same position for a long time as it produces excessive amounts of heat.