Unilateral Hemilaminectomy Approach for Resection of Thoracic Spinal Meningiomas: A Stepwise Surgical Technique Demonstration for Trainees

Conventionally, the bilateral laminectomy approach is selected for spinal meningiomas; however, a growing number of surgeons prefer the unilateral hemilaminectomy approach because of its lower invasiveness and shorter operating time. In this video, we demonstrate the resection of a thoracic spinal meningioma via a unilateral hemilaminectomy. A 61-year-old man presented with a 10-month history of progressive ascending sensory loss extending from the left toe to the bilateral nipple levels, with imaging findings suggestive of a thoracic spinal meningioma. A unilateral hemilaminectomy was performed, and Simpson grade II removal was achieved. Piecemeal tumor removal was performed to avoid additional compression of the spinal cord and maintain a bloodless operative field, which we believe are key microsurgical techniques for successful spinal meningioma resection. Unilateral hemilaminectomy combined with the microneurosurgical technique described in the video is safe and effective for spinal meningiomas that markedly compress the spinal cord.