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Letter to Editor

Hemilaminectomy for an Intradural Extramedullary Lesion: A Minimal Invasive Approach in a Young NF2 Patient

Alberto D’ Amico

Valentina Baro

Giulia Melinda Furlanis

Luca Sartori

Luca Denaro

Andrea Landi

Recieved on: 2023-07-17, Accepted on: 2023-08-26, Published on: 2023-08-29

Abstract

Neurofibromatosis type 2 (NF2) is a rare autosomal disorder characterized by arising of multiple lesions in several organs with different histology. For this reason, NF2 patients underwent many surgical procedures during their lifetime and spinal tumors represent an important part of them.  Intradural extramedullary (IDEM) tumors amount of the two-thirds of spinal lesions. In NF2 population intradural extramedullary (IDEM) tumors are common and are a challenging entity due their tendency to be multiple, to arise in the whole of spine. Indeed, due to several procedures are needed to remove them during their lifetime neurological function as well as the spine stability could be compromised.

To date, a gross total resection remain the goal standard of treatment of IDEM tumors, and several microsurgical techniques are described. To decide which surgical approach performs and to achieve a gross total resection an accurate preoperative planning is paramount. We described a case of 19-year-old male underwent surgery for a C4 intradural extramedullary lesion performing a left unilateral approach with a tailored and a minimally invasive C4 hemilaminectomy.

Even if this approach is widely described in literature, the hemilaminectomy has not been performed before in NF2 patients.

To the best of our knowledge, a hemilaminectomy to achieve a gross total resection in NF 2 patient has not been highlighted yet. Mini invasive approach is attractive and should be encouraged in NF2 patients.

Keywords

Hemilaminectomy; Neurofibromatosis; Minimally Invasive Surgery; IDEM