Midline spinous process splitting laminoplasty in a newborn with thoracolumbar epidural hematoma: a bone-sparing procedure based on anatomy and embryology

Childs Nerv Syst. 2020 Dec;36(12):3103-3108. doi: 10.1007/s00381-020-04611-9. Epub 2020 Apr 14.

Abstract

Spinal epidural hematoma (SEH) is a rare condition leading to spinal cord compression after trauma, surgery, or other. In 40% of the cases, the cause is unknown or unidentified. Due to the absence of specific symptoms, the diagnosis is often delayed. The mainstay of treatment is urgent evacuation of the hematoma. The choice of the surgical technique is surgeon-dependent and ranges from simple decompression and hematoma evacuation to variable combinations of decompression and reconstruction of the posterior spinal arch. To our knowledge, we describe the youngest case in the literature of a thoracolumbar SEH in a newborn with hemophilia A which was evacuated by spinous process splitting laminoplasty (SPSL). SPSL was chosen to avoid damaging the primary ossification centers, preserve the paravertebral musculature, and evade the sequelae of multilevel laminectomies. In our opinion, this technique should be propagated in the pediatric population for accessing the posterior and posterolateral spinal canal.

Keywords: Epidural; Hematoma; Pediatrics; Spinal.

MeSH terms

  • Child
  • Decompression, Surgical
  • Hematoma, Epidural, Cranial*
  • Hematoma, Epidural, Spinal* / diagnostic imaging
  • Hematoma, Epidural, Spinal* / etiology
  • Hematoma, Epidural, Spinal* / surgery
  • Humans
  • Infant, Newborn
  • Laminectomy
  • Laminoplasty*