Hemilaminectomy as an Approach for Intradural Extramedullary Tumor Removal

OBJECTIVE: To evaluate the safety and effectiveness of hemilaminectomy as a minimally invasive approach for the resection of intradural extramedullary (IDEM) spinal tumors, with emphasis on functional outcomes and complication rates. METHODS: This prospective observational study included 27 patients (mean age 50 years; 48% male) with IDEM tumors treated via hemilaminectomy between 2021 and 2025 in a single reference center. Surgical planning was based on preoperative MRI, neurological evaluation, and McCormick functional grading. All procedures were performed with intraoperative neurophysiological monitoring. Postoperative outcomes, including functional recovery and complications, were assessed over a follow-up period of 12 to 48 months. RESULTS: Tumors were predominantly located in the thoracic spine (48%), with schwannomas accounting for 63% of cases. Gross total resection was achieved in all patients. The mean McCormick score improved from 2.1 preoperatively to 1.1 postoperatively, corresponding to a 47% functional improvement. Complications occurred in 7.4% of cases, including one surgical site infection and one cerebrospinal fluid fistula. CONCLUSIONS: Hemilaminectomy is a safe and effective minimally invasive approach for IDEM tumors, providing excellent functional outcomes with low complication rates while preserving spinal stability. These findings support its use in centers with appropriate microsurgical expertise.