MIS removal of extraforaminal lumbar spine schwannoma using MAS–TLIF retractor: technical note

F, Calvanese; Boari, Nicola; Spina, Alfio; Gagliardi, Filippo; Bailo, Michele; Mortini, Pietro

doi:10.1080/02688697.2021.1888872

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Con-comitant arthrodesis and instrumentation may be necessary to reduce the risk of spinal instability, further adding to surgical morbidity [3,11,12]. In recent years, a number of mini-open or MIS approaches to lumbar extraforaminal schwannomas have been described [12][13][14][15][16]. Minimally invasive techniques allow for less muscle and ligamentous disruption, are associated with less blood loss, and shorter postoperative length of stay, thus lessening surgical morbidity [4,15].…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Oblique Retroperitoneal Approach for Extraforaminal Lumbar Schwannoma: Technical Challenges and Literature Review

Kramer,

Elhamdani,

Zaki

et al. 2024

J Minim Invasive Spine Surg Tech

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Traditional surgical techniques for extradural lumbar schwannomas are associated with considerable morbidity, including spinal instability and injury to the viscera and lumbar plexus. Minimally invasive approaches decrease soft tissue damage, blood loss, and postoperative length of stay. For select extraforaminal schwannomas, a minimally invasive lateral transpsoas approach affords a direct surgical corridor. A 53-year-old obese female presented with 1 year of left iliopsoas weakness and L3 radiculopathy refractory to conservative management. Lumbar spine magnetic resonance imaging revealed a contrast-enhancing mass within the left psoas muscle consistent with an extraforaminal L3 schwannoma. The patient underwent minimally invasive oblique retroperitoneal surgical resection. Intraoperatively, the nerve root was splayed over the superior-lateral portion of the tumor limiting us to subtotal resection with nerve root preservation. The patient had improvement of pain and weakness that persisted at a 3-month follow-up. A minimally invasive lateral/oblique transpsoas approach provides a direct surgical approach for extraforaminal schwannoma. Patient body habitus and the nerve root relationship to the tumor may present limitations for the safe extent of resection.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Oblique Retroperitoneal Approach for Extraforaminal Lumbar Schwannoma: Technical Challenges and Literature Review

Kramer,

Elhamdani,

Zaki

et al. 2024

J Minim Invasive Spine Surg Tech

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“…This may be explained by the fact that the exoscope allows for remote movement of the optical head using the foot pedal. In a deep and narrow cavity such as when performing the hemilaminectomy approach, 19 instruments and fingers easily get in front of the optical trajectory. With the exoscope, it is possible to make even slight adjustments for optimal visualization while keeping both hands in the operative field.…”

Section: Benefits Of the Exoscope In Surgery For Davfsmentioning

confidence: 99%

Digital exoscope versus surgical microscope in spinal dural arteriovenous fistula surgery: a comparative series

Auricchio,

Calvanese,

Vasankari

et al. 2024

Neurosurgical Focus

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OBJECTIVE Surgical treatment of spinal dural arteriovenous fistulas (DAVFs) has been reported to be superior to endovascular treatment in terms of occlusion of the fistula. Despite the increased availability of digital 3D exoscopes, the potential benefits of using an exoscope in spinal DAVF surgery have not been studied. The purpose of this study was to report and compare the results of exoscope- and microscope-assisted surgery for spinal DAVFs. METHODS All consecutive adult patients (≥ 18 years of age) treated surgically for spinal DAVFs from January 2016 to January 2023 in a tertiary neurosurgical referral center were included. All patients were operated on by one neurosurgeon. Their pre- and postoperative clinical findings, imaging studies, and intra- and postoperative events were evaluated and surgical videos from the operations were analyzed. RESULTS Altogether, 14 patients received an operation for spinal DAVF during the study period, 10 (71%) with an exoscope and 4 (29%) with a microscope. The DAVFs were most commonly located in the lower parts of the thoracic spine in both groups. The duration of exoscopic surgeries was shorter (141 vs 151 minutes) and there was less blood loss (60 vs 100 ml) than with microscopic surgeries. No major surgical complications were observed in either group. Of the 14 patients, 10 had gait improvement postoperatively: 7 (78%) patients in the exoscope group and 3 (75%) in the microscope group. None of the patients experienced deterioration following surgery. CONCLUSIONS Exoscope-assisted surgery for spinal DAVFs is comparable in safety and effectiveness to traditional microscopic surgery. With practice, experienced neurosurgeons can adapt to using the exoscope without major additional risks to the patient.

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Digital 3D Exoscope is Safe and Effective in Surgery for Intradural Extramedullary Tumors: A Comparative Series

Calvanese,

Auricchio,

Vasankari

et al. 2024

World Neurosurgery

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MIS removal of extraforaminal lumbar spine schwannoma using MAS–TLIF retractor: technical note

Cited by 4 publications

References 17 publications

Minimally Invasive Oblique Retroperitoneal Approach for Extraforaminal Lumbar Schwannoma: Technical Challenges and Literature Review

Minimally Invasive Oblique Retroperitoneal Approach for Extraforaminal Lumbar Schwannoma: Technical Challenges and Literature Review

Digital exoscope versus surgical microscope in spinal dural arteriovenous fistula surgery: a comparative series

Digital 3D Exoscope is Safe and Effective in Surgery for Intradural Extramedullary Tumors: A Comparative Series

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