Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment

Laminectomy can be accomplished using the craniotome with a footplate attachment, and the technique has been advanced as a superior alternative to using a high-speed drill-driven burr and Kerrison rongeurs. Laminectomy can be accomplished more rapidly and with less bone destruction, an advantage whe...

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Autores principales: Houten, John K, Harter, David H, Schwartz, Amit Y
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184105/
https://www.ncbi.nlm.nih.gov/pubmed/34113510
http://dx.doi.org/10.7759/cureus.14893
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author Houten, John K
Harter, David H
Schwartz, Amit Y
author_facet Houten, John K
Harter, David H
Schwartz, Amit Y
author_sort Houten, John K
collection PubMed
description Laminectomy can be accomplished using the craniotome with a footplate attachment, and the technique has been advanced as a superior alternative to using a high-speed drill-driven burr and Kerrison rongeurs. Laminectomy can be accomplished more rapidly and with less bone destruction, an advantage when planning laminoplasty. There is, however, scant literature describing complications of dural laceration using this technique. A 48-year-old male underwent T7-10 laminectomy for resection of an intramedullary spinal cord tumor. During the upward cut of the hemi-lamina at T7-9, a dural laceration occurred that proved not amenable to direct suture closure. The dural was closed with a dural patch placed along the inner surface of the dura and a fat graft on the outer surface with adjunctive use of a lumbar drain. While the footplate laminectomy technique has merits touted in prior publications, including the ability to open the spinal canal quickly at numerous levels and an enhanced ability to achieve an osteoplastic laminoplasty, surgeons should be cognizant of the risk of associated dural laceration. We believe that it is important to emphasize that the initial placement of the lip of the footplate must be well-seated under the inferior aspect of the lowest lamina and over the ligamentum flavum and that the footplate should not be directed beyond the border of the laminae and facet, as this can result in dura and root injury.
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spelling pubmed-81841052021-06-09 Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment Houten, John K Harter, David H Schwartz, Amit Y Cureus Neurosurgery Laminectomy can be accomplished using the craniotome with a footplate attachment, and the technique has been advanced as a superior alternative to using a high-speed drill-driven burr and Kerrison rongeurs. Laminectomy can be accomplished more rapidly and with less bone destruction, an advantage when planning laminoplasty. There is, however, scant literature describing complications of dural laceration using this technique. A 48-year-old male underwent T7-10 laminectomy for resection of an intramedullary spinal cord tumor. During the upward cut of the hemi-lamina at T7-9, a dural laceration occurred that proved not amenable to direct suture closure. The dural was closed with a dural patch placed along the inner surface of the dura and a fat graft on the outer surface with adjunctive use of a lumbar drain. While the footplate laminectomy technique has merits touted in prior publications, including the ability to open the spinal canal quickly at numerous levels and an enhanced ability to achieve an osteoplastic laminoplasty, surgeons should be cognizant of the risk of associated dural laceration. We believe that it is important to emphasize that the initial placement of the lip of the footplate must be well-seated under the inferior aspect of the lowest lamina and over the ligamentum flavum and that the footplate should not be directed beyond the border of the laminae and facet, as this can result in dura and root injury. Cureus 2021-05-07 /pmc/articles/PMC8184105/ /pubmed/34113510 http://dx.doi.org/10.7759/cureus.14893 Text en Copyright © 2021, Houten et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Houten, John K
Harter, David H
Schwartz, Amit Y
Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment
title Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment
title_full Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment
title_fullStr Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment
title_full_unstemmed Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment
title_short Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment
title_sort dural tear during thoracic laminectomy using craniotome with footplate attachment
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184105/
https://www.ncbi.nlm.nih.gov/pubmed/34113510
http://dx.doi.org/10.7759/cureus.14893
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