T1/2 Posterior Thoracic Laminoplasty( fixation with DePuy Synthes Matrix Neuro mini-plates) and excision of an intradural tumour


Subscribe to get full access to this operation and the extensive Spine Surgery Atlas.


Learn the T1/2 Posterior Thoracic Laminoplasty( fixation with DePuy Synthes Matrix Neuro mini-plates) and excision of an intradural tumour surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the T1/2 Posterior Thoracic Laminoplasty( fixation with DePuy Synthes Matrix Neuro mini-plates) and excision of an intradural tumour surgical procedure.

Spinal tumours are generally rare and can be classified into:

  • Extradural tumours
  • Intradural extramedullary tumours
  • Intradural intramedullary tumours

The case described involves a patient with Neurofibromatosis Type 2 with an intradural extramedullary tumour in the upper thoracic spine at the T1/T2 level.

Neurofibromatosis Type 2 (NF2) is a rare genetic condition which can be inherited as an autosomal dominant pattern.  It is caused by a mutation in the NF2 gene which regulates the production of a protein called merlin/schwannomin which is a tumour suppressor protein.  NF2 patients can develop benign fibrous tumours of the skin (cutaneous neurofibromas), bilateral vestibular schwannomas, meningiomas and gliomas.  Bilateral vestibular schwannomas are diagnostic of NF2.  The incidence is approximately 1 in 33000.

The clinical presentation will depend on the location of the tumour and typically if there is a lesion causing compression of the spinal cord or nerve roots then surgery is indicated.  Spinal nerve sheath tumours are most often benign but in very rare cases can transform into malignant tumours.

The operating surgeon will need to assess the location of the tumour in relation the spinal cord in order to decide on the safest surgical approach.  In principle, the technique used should keep manipulation of the spinal cord to the minimum with a view to mobilising tumour away from critical structures and into a ‘safer’ zone.  Internal debulking of the tumour mass is also utilised to facilitate tumour mobilisation and removal.  Sacrificing a nerve root can be considered if the aim is for tumour excision and the potential neurological deficit is not seen as being significant.  The surgical strategy and risk of post-operative neurological deficits needs to be discussed with the patient prior to surgery.

Author:Navin Furtado FRCS.

Institution: The Queen Elizabeth Hospital, Birmingham, UK

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


  • Did you find this technique helpful?
  • YesNo



Logo Logo Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo Logo