The Optimal Surgical Approach to Intradural Spinal Tumors: Laminectomy or Hemilaminectomy?

Goodarzi, Amir; Clouse, Jared W.; Capizzano, Tatiana; Kim, Kee D.; Panchal, Ripul R.

doi:10.7759/cureus.7084

Cited by 17 publications

(23 citation statements)

References 21 publications

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“…Ultimately, the approach will depend on the type and localization of the tumor and the surgeon's ability to handle nerves and resect bones. A minimally invasive approach can always be helpful for patients if tumor removal can be performed safely and reliably [ 2 , 4 , 9 ]. Several reports compared spinal cord tumor removal techniques, but none of them clearly describes the appropriate site and level of indication for laminectomy or laminoplasty [ 2 - 4 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…A minimally invasive approach can always be helpful for patients if tumor removal can be performed safely and reliably [ 2 , 4 , 9 ]. Several reports compared spinal cord tumor removal techniques, but none of them clearly describes the appropriate site and level of indication for laminectomy or laminoplasty [ 2 - 4 , 10 ]. The introduced system is highly useful in terms of versatility because we can plan various surgical techniques [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Novel Technique of Mixed Reality Systems in the Treatment of Spinal Cord Tumors

Aoyama¹,

Anazawa²,

Hotta³

et al. 2022

Cureus

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Several reports have compared spinal cord tumor removal techniques but none have clearly described the appropriate site and level of indication for laminectomy or laminoplasty. The approach method for tumor removal depends on the type and localization of the tumor and the surgeon's skill. Therefore, a system that can suggest various surgical techniques is useful for spinal cord tumor surgery. The mixed reality system introduced in this paper is an excellent system that can suggest various surgical procedures. Using this system for spinal cord tumor removal, we made the surgery less invasive; therefore, we introduced this system and demonstrated its usefulness. Stereoscopic data of the patients with spinal cord tumors were obtained from preoperative myelogram-CT data. Stereoscopic laminectomy models including tumors were created using Blender, a free three-dimensional (3D) image editing software. We observed these data as 3D object images using a head-mounted display (HMD). This HMD is commercially available and relatively inexpensive. The surgical procedure is determined by considering those 3D images, radiological diagnosis, and the skill of surgeons. Intraoperative confirmation of the laminectomy site could be performed using the HMD. The 3D visualization of pathological conditions resulted in correct preoperative surgical planning and less invasive surgery in all five cases. Stereoscopic images using HMDs allow us a more intuitive understanding of the positional relationship between the tumor and spinal structure. These 3D object images can bring us more accurate preoperative planning and proper determination of surgical methods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Novel Technique of Mixed Reality Systems in the Treatment of Spinal Cord Tumors

Aoyama¹,

Anazawa²,

Hotta³

et al. 2022

Cureus

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“…[7] In accordance, the study by Caroli et Management of spinal IDEM tumors is tumor resection surgery in generally. [10] A retrospective study suggested a significant improvement in neurological deficit posttumor resection on patients with spinal IDEM tumor, regardless of the percentage of tumors occupying the intradural space, the degree of preoperative symptoms, and the duration of symptoms. [9] Study by Goodarzi et al suggested that there was no significant difference in the length of operation, estimated blood loss, or in the length of hospital stays between the spinal IDEM tumor's approaches of laminectomy or hemilaminectomy.…”

Section: Discussionmentioning

confidence: 99%

“…[3], [7] Management of spinal IDEM tumors is tumor resection surgery but biopsy is the only method to definitively confirm diagnosis through tumor resection surgery. [8], [9], [10] The pathognomonic histologic feature of a meningioma is spherical formations of meningothelial cells, called whorls, which eventually mineralize into psammoma bodies. A range of histologic patterns and findings can be seen that often mimic other soft tissue tumors, as indicated by the numerous variants just among benign grade I tumors: meningothelial, fibrous, transitional, psammomatous, angiomatous, microcystic, secretorym, lymphoplasmacyte-rich and metaplastic.…”

Section: Introductionmentioning

confidence: 99%

Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review

Siregar¹,

Ibrahim

2021

AANHS-J

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Abstract Introduction: Intradural extramedullary (IDEM) tumors are benign neoplasms arising in the spinal canal about two-thirds of primary spinal tumors and 15% of tumors affecting the Central Nervous System. Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like, and incidence in the literature only ranging from 0.1% to 3.1%. Pain is the most clinical symptom, weakness and sensory changes also occur frequently. Magnetic resonance imaging (MRI) is the standard modality for the radiologic diagnosis of meningioma. Case Report: A patient, 35 years old man with a diagnosis of intradural extramedullary spinal meningioma (IDEM) en-plaque with calcification, confirmed by the symptoms, workups such as spinal MRI, and intra-operative findings. The patient was successfully treated surgically with laminectomy and total tumor resection with a posterior approach. Discussion: Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like manner around the spinal cord can involve dura extensively with significant neurological deficits. Patient was with lower limb weakness, and had a history of back pain radiating to the right limb for the last 1 year. Spinal meningiomas are primarily found in the Intradural Extramedullary, and the tumor diagnosis is typically fairly straight forward based on radiologic findings. Meningiomas are most commonly found in the thoracic region of the spine. In this case from MRI Imaging was revealed a mass in thoracic region of the spine pressing the spinal cord anteriorly. The management of spinal en-plaque meningioma is tumor resection surgery. A retrospective study suggested a significant improvement in neurological deficit post-tumor resection on patients with spinal IDEM tumor. Conclusion: Spinal meningioma is a reasonably frequently found case of a spinal tumor but spinal en-plaque meningiomas are rarely found. MRI scan is the radiological gold standar diagnose spinal en-plaque meningiomas. Patient was successfully treated by total tumor resection using the laminectomy method and tumor resection with a posterior approach without any postoperative complications observed.

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“…Different surgical techniques are used for excision of IDEM spinal tumors. Laminectomy has been the classic approach and also hemilaminectomy and they are still used for that despite the development of minimally invasive technique that aim to avoid potential complication of the classic approach, the laminectomy allows for better exposure, convenient work, and continue to be the preferred method for resection of large tumors with complex morphology (9) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Intradural Extramedullary Spinal Tumors Management: Single Institutional Experience

Arab¹,

Eltantawy²,

Elmaghrabi³

2022

The Egyptian Journal of Hospital Medicine

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Background: Surgical treatment of Symptomatic intradural extramedullary spinal (IDEM) tumors is the most effective treatment. The development in diagnostic and surgical techniques helped for early diagnosis and excellent surgical results. The aim of the present study is to overview the management experience of IDEM spinal tumor cases in our university hospital for upgrading our competency and sharing it with other institutions. Patients and methods: A retrospective study was conducted in which the medical records of patients who had surgical treatment for IDEM spinal tumors in between the periods from May 2015 to May 2020 in Benha University hospitals were evaluated and reviewed. Results: A total of 23 patients, 11 males and 12 females were included with a mean age of 41.04 (SD 10.32) years and mean follow up of 22.9 (SD 7.52) months. Nerve sheath tumor (neurofibromas and schwanomas) accounted for most of tumors (52.2%) followed by meningiomas (34.8%). The 6 cases managed using IONM had excellent outcome. hemilaminectomy was done in 4 (17.4%) patients, and fusion was needed in 4 (17.4%) patients. Patients' functional outcome was assessed using Frankel grades; we had postoperative 8E, 4D, and 1C grades compared to 7E, 8D, 5C, and 3B preoperatively, and 22 (95.7%) patients had improvement. VAS showed significant from 8.57 (SD 1.21) preoperatively to 1.33 (SD 1.39) at last follow up visit (P value <0.001). Conclusion: Surgical treatment of symptomatic an IDEM spine tumor is successful and safe with good functional outcome and pain improvement. Most tumors are benign. Use of IONM is helpful and small unilaterally located tumor can be approached via hemilaminectomy.

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The Optimal Surgical Approach to Intradural Spinal Tumors: Laminectomy or Hemilaminectomy?

Cited by 17 publications

References 21 publications

A Novel Technique of Mixed Reality Systems in the Treatment of Spinal Cord Tumors

A Novel Technique of Mixed Reality Systems in the Treatment of Spinal Cord Tumors

Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review

Evaluation of Intradural Extramedullary Spinal Tumors Management: Single Institutional Experience

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