JOURNAL DE NEUROCHIRURGIE
Volume 14, Numéro 1, Pages 65-71
2018-06-15
Extensive Spinal Epidural Hematoma Removed By A Multilevel Bilateral Alternating Hemi-laminectomy
Auteurs : Moumouni Abdelkader .
Résumé
Objective and Importance : Extensive spinal epidural hematoma (SEH) creates another treatment challenge because the aim of surgery is to remove the hematoma without devastating damage to the spine. We report herein, to the best of our knowledge, the first case of extensive SEH treated by a multilevel bilateral alternating hemi-laminectomy which may reduce the potential risk of associated spinal deformity often linked to multilevel laminectomy. Clinical Presentation : A 49 year-old woman was admitted to our Department for flaccid paraplegia. An emergent MRI showed an elongated spindle shaped lesion at the dorsal epidural space extending from T1 to T12, suggestive of SEH, with the most compressive bulk of the lesion extending from T3 to T9. Technique : The hematoma was successfully removed via a bilateral alternating hemilaminectomy, involving successively one lamina and the underneath opposite lamina, from T 4 to T 8. Conclusion : Extensive posterior SEH could be managed by bilateral alternating hemilaminectomy, in place of devastating laminectomy which impairs the stability of the posterior vertebral column and predispose to spinal instability and deformity, notably in childhood.
Mots clés
Spinal epidural hematoma ; Bilateral alternating hemi-laminectomy ; Surgical technique.
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