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KMID : 0388720220290010001
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Journal of Korean Society of Spine Surgery
2022 Volume.29 No. 1 p.1 ~ p.9
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Modified “Lift up” Laminoplasty ? A Novel Surgical Technique For Long Segment Epi/Intradural Tuberculoma: A Case Series
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Vijayan Selvin Prabhakar
Gerber Christopher
Basu Anindya
Pathak Debajyoti
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Abstract
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Study Design: Orginal article.
Objective: Spinal tuberculosis presents mostly as a spondylodiscitis or a discitis, rarely as non-osseous tuberculoma. They can be either extradural, intradural extramedullary, or intramedullary lesions. Rarely they present as an intradural extramedullary (IDEM) tuberculomas or spinal epidural abscess (SEA). We would like to describe the surgical technique called the modified lift-up laminoplasty, for management of long segment organised IDEM/SEA tuberculomas.
Summary of Literature Review: ATT continues to be the gold standard treatment for tuberculosis while surgery is indicated in a select few. Combination has given successful outcomes and fusion in about 97% of cases.
Material and Methods: Retrospective review of the records for lift up laminoplasty in the past two years was done. All the relevant records and imaging of the patients were retrieved and briefed.
Results: Four patients were included in the study. Two patients were diagnosed with IDEM tuberculomas, one case of tubercular SEA with and without osseous involvement each. All were managed with modified lift up laminoplasty technique. Three patients had good clinical improvement at the final follow up.
Conclusions: An early MRI helps in early diagnosis of atypical spinal tuberculosis. The technique of modified lift up laminoplasty gives dual advantage of adequate working space, preserves the posterior tension band ligaments and avoids long segment instrumented fixation. It is an efficient method for long segment epi/intradural organised granulation tissue.
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KEYWORD
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Laminoplasty, Lift up laminoplasty, Epidural abscess, Intradural tuberculoma, Spine tuberculosis
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