Technical note: unilateral hemilaminotomy for intradural lesions (UHIL)

The authors report on a case of a 38-year-old female presenting with progressive cervical myelopathy, including gait and balance dysfunction and limb paraesthesia over a 2-year time period. Imaging revealed a C3 intradural lesion consistent with a meningioma. The lesion was located to the left of midline, causing significant cord compression with signal change on T2WI MRI. Surgical removal of the lesion was recommended as the treatment of choice. Options for canal access were discussed including a standard laminectomy with removal of the midline structures including spinous process and bilateral lamina, versus a unilateral laminotomy and sparing of the contralateral muscle and spinous process. The unilateral approach was preferred and performed for removal of the lesion, and documented in the presented video.