April 2026, Volume 4, Issue 4

Author

Hitesh Bhaliya, Arun Balaji, Suresh Jayabalan, JKBC Parthiban and Jeevithan Shanmugam

Abstract

Introduction and Objectives: Intradural extramedullary (IDEM) spinal tumors constitute the most common group of intraspinal tumors and frequently present with progressive neurological deficits due to spinal cord or nerve root compression. Conventional laminectomy, though widely used, is associated with significant postoperative morbidity and spinal instability. With advancements in minimally invasive spine surgery, unilateral hemilaminotomy has emerged as an alternative approach aimed at preserving spinal stability while achieving adequate tumor excision. Materials and Methods: This hospital-based longitudinal observational study was conducted in a tertiary care neurosurgical center between January 2014 and December 2018. A total of 30 patients with IDEM tumors who underwent surgical excision using unilateral hemilaminotomy were included. Ethical approval was obtained, and written informed consent was secured from all participants. Preoperative evaluation included detailed neurological assessment using Nurick's grading and magnetic resonance imaging for tumor localization. Results: The study population had a mean age of 51 years with equal gender distribution. Thoracic spine was the most commonly involved region. Gross total tumor excision was achieved in all cases without conversion to conventional laminectomy. There was a statistically significant improvement in neurological status, with mean Nurick grade improving from 2.63 preoperatively to 0.30 postoperatively (p < 0.0001). Schwannomas were the most common histopathological diagnosis, followed by meningiomas. Conclusion: Minimally invasive unilateral hemilaminotomy is a safe and effective surgical approach for IDEM tumors, providing excellent neurological outcomes with minimal morbidity while preserving spinal stability. This technique represents a reliable and durable alternative to conventional laminectomy.