• World Neurosurg · Jan 2020

    Case Reports

    MICROSURGICAL RESECTION OF INTRASPINAL BENIGN TUMORS USING NON-EXPANSILE TUBULAR ACCESS: TUBULAR INTRASPINAL TUMORS RESECTION.

    • José Antonio Soriano Sánchez, Manuel Eduardo Soto García, Sergio Soriano Solís, Manuel Rodríguez García, Paul Trejo Huerta, Oscar Sánchez Escandón, Enrique Raúl Flores Soria, and José Alberto Israel Romero-Rangel.
    • Spine Clinic, The American-British Cowdray Medical Center I.A.P. Campus Santa Fe, Mexico City, Mexico.
    • World Neurosurg. 2020 Jan 1; 133: e97-e104.

    BackgroundIntraspinal tumors are 10 to 15 times less common than brain tumors. The midline approach with extensive laminectomies represents the current gold-standard for resection, causing instability, muscle damage, and kyphosis among other well-known complications. Minimally invasive series reported their results using retractor-based systems. We analyzed a patient series treated with a non-expansile tubular approach, describing the technique, grade of resection, and clinical outcomes.MethodsA series of consecutive cases operated between 2016 and October 2018 were analyzed retrospectively. The database included age, sex, clinical presentation, intraspinal location (intra/extradural), number of laminotomies, grade of resection, surgical time, bleeding, and follow-up. The initial and follow-up clinical condition was analyzed using the Frankel scale.ResultsA total of 13 patients underwent surgery: 3 intraspinal/extradural (23%), 8 intradural/extramedullary (61.5%), and 2 intramedullary tumors (15.3%); these were classified as 5 meningiomas (38.4%), 4 neurofibromas (30.7%), 2 schwannomas (15.3%), 1 hemangioblastoma (7.6%), and 1 astrocytoma (7.6%). Eleven (84.61%) patients had complete motor improvement, 1 patient had partial improvement, and 1 patient had no improvement (7.6% each). An 18-mm working channel tube was used for extramedullary lesions and 20-mm tubes for intramedullary injuries. Total tumor resection was achieved in 11 patients (84.6%) and subtotal in 2 patients (15.38%) corresponding to intramedullary tumors.ConclusionsAlthough this study consisted of a small series, we have shown the possibility of resecting intraspinal tumors (some intradural-intramedullary) with non-expansile tubes in a safe and effective way with no complications. Most of the patients had complete neurological improvement at the end of follow-up.Copyright © 2019 Elsevier Inc. All rights reserved.

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