• Francesco Calvanese, Anna Maria Auricchio, Ville Vasankari, Rahul Raj, GallèCamille Louise ClaudineCLCDepartment of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands., Mika Niemelä, and Martin Lehecka.
• Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
• World Neurosurg. 2024 Apr 1; 184: e1e8e1-e8.

BackgroundDigital 3D exoscopes have been shown to be comparably safe and effective as surgical microscopes in complex microneurosurgical procedures. However, the results of exoscopic spinal tumor surgeries are scarce. The purpose of this study is to compare results of a transition from microscope to exoscope in surgeries for spinal intradural extramedullary tumors.MethodsWe included all consecutive patients with intradural extramedullary spinal tumors operated on by the senior author during January 2016 to October 2023. The 3D exoscope was used in the latter half of the series from November 2020. We evaluated pre- and postoperative clinical findings, imaging studies, intra- and postoperative events, and analyzed surgical videos from the operations retrospectively.ResultsWe operated 35 patients (exoscope n = 19, microscope n = 16) for intradural extramedullary tumors (meningioma n = 18, schwannoma n = 12, other n = 5). Tumors in the cervical and thoracic spine were more common than in the lumbar region. The duration of surgery was slightly longer (median 220 vs. 185 minutes) in the exoscope group. However, the rate of gross total resection of the tumor was higher (81% vs. 67%) and the tumors more often located anteriorly to the spinal cord (42% vs. 13%) in the exoscope group. No major complications (i.e., permanent motor deficit or postoperative hematoma) occurred in either group. We saw postoperative gait improvement in 81% and 85% of the patients with preoperative deterioration of gait after exoscopic and microscopic surgeries, respectively.ConclusionsThis study demonstrates that exoscope-assisted surgery for spinal intradural extramedullary tumors is comparable in safety and effectiveness to traditional microscopic surgery.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

19 keywords...

hide…