The use of minimally invasive approaches to resect intradural extramedullary spinal cord tumors

Konovalov, N A; Shevelev, I. N.; Nazarenko, A G; Asiutin, D S; Korolishin, V A; Тимонин, С. Ю.; Закиров, Б А; Onoprienko, R A

doi:10.17116/neiro201478624-36

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…Sometimes only hemilaminectomy may suffi ce for IDEM tumor resection. 14,15,26,29 Surgical results of IDEM tumors are excellent and even long lasting preoperative neurologic defi cit may be improved and reversed postoperatively. Although surgical excision remains primary treatment option for most of IDEM tumors, radiosurgery offers an alternative therapeutic modality, especially for recurrent and residual lesions or when surgery is contraindicated.…”

Section: Discussionmentioning

confidence: 99%

“…These days although there is increasing trend of performing hemilaminectomy for the excision of IDEM masses believing that this procedure is less invasive and prevents instability of spines. 14,15,29 In our center we routinely do standard laminectomy to resect IDEM tumors and have not found a single patient having ustable spines on regular follow up of 5 to 17 years.Published series also did not reaveal any difference between the outcome of patients who underwent hemilaminectomy and laminectomy for IDEM tumor excision. 18,29 Postoperative complication rate in our series was 12% which is similar to published series.…”

Section: Teratomasmentioning

confidence: 99%

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Functional Outcome of Intradural Extramedullary Spinal Tumors after Surgical Resection

et al. 2016

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Intradural extramedullary (IDEM) spinal tumors account about 40% of all intraspinal tumors and mainly represented by nerve sheath tumors and meningiomas. These two tumors represent about 55% of IDEM tumors and other rare tumors are dermoid, epidermoid, lipomas, metastatic tumors, paragangliomas etc.Technical advances in imaging techniques, MRI and surgical procedures have brought about excellent clinical results of IDEM tumors after surgery in last two decades. However, a small percentage of patients still present poor postoperative neurological outcome due to delayed in diagnosis and surgical intervention, severity of preoperative neurological defi cits and adverse pathology.The aim of this study is to analyze and discuss about the surgical outcome of 65 IDEM tumors operated in twelve years’ period.This is a retrospective study of 65 patients who were operated for IDEM tumors, between 1999 and 2012 in Department of Neurosurgery. One patient who had IDEM arteriovenous malformation was excluded from the study.Neurological outcome was scaled by McCormick’s grading. Follow up period ranged for 5 years to 17 years.After the clinical evaluation, all the patients suspected of having spinal tumors were subjected for MRI with Gadolinium enhancement of presumed level of spine based on neurological findings. Total excision of all IDEM tumors was performed using operating microscope. No intraoperative neurophysiological monitoring was used.There were 40 male and 25 female and age ranged from 10 to 80 years. Most common IDEM tumors were nerve sheath tumors (44), meningiomas (13), hydatid cyst (2), dermoid/epidermoid (2), arachnoid cyst (2) and n were thoracic, cervical and lumbar spines.Total tumor excision was performed in all cases. Post operative Complications rate was 12.3% (7) and common complications included were CSF Leak (5), wound infection (2), meningitis (1).There was no surgery related mortality. Postoperatively 60 patients had improved neurological status, 5 patients had stable neurology. There was no postoperative neurological deterioration.On followed up period 2 patients showed features of recurrence of tumor in 5 years’ period and underwent resurgical treatment. Those two patients with recurrent tumors were nerve sheath tumors.Majority of IDEM tumors are benign and total cure is possible in almost all cases if tumor is excised totally. Excellent neurological recovery has been observed in more than 95% of cases.Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 73-80

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Section: Discussionmentioning

confidence: 99%

Section: Teratomasmentioning

confidence: 99%

Functional Outcome of Intradural Extramedullary Spinal Tumors after Surgical Resection

et al. 2016

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“…Although each study of intradural extramedullary tumors used different scale as a measuring tool to assess the pre and postoperative neurological status, all of them reported significant neurological improvement after surgery. Konovalov et al, 11 reported that 50% of patients moved to higher functional class of McCormick scale after laminectomy and resection of tumor. Similarly, Gu et al, 6 revealed that 93% of their patients had improved frankel grade, whereas 7% of patients had no change in their grade after surgery.…”

Section: As Most Of Intradural Extramedullary Tumors Are Benign Wellmentioning

confidence: 99%

Functional Outcomes following Surgical Management of Intradural Extramedullary Spinal Cord Tumors

Elzoghby

Baky

2015

Egyptian Spine Journal

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Background Data: Intradural extramedullary tumors are mostly benign lesions that often present late due to their slow rate of growth. Recent advances in the field of neuro-imaging have greatly increased the ability to identify these tumors in early stages. The most effective treatment modality for these tumors is gross total resection, which can sometimes be associated with neurological morbidity and functional impairment. Purpose: to evaluate the functional outcomes following surgical excision of intradural extramedullary spinal tumors. Study Design: This is a retrospective cohort clinical case study.

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“…Minimally invasive approaches for intradural tumors have been found to be safe and effective. [1][2][3][4][5] A microscope 6 or endoscope 7 has been used recently in such cases. Minimally invasive surgical (MIS) approaches using expandable or nonexpandable tubular retractor 8 or interlaminar approaches 9 have been described to reduce trauma-related instability with comparable outcome.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Management of Spinal Intradural Extramedullary Tumors

Parihar

Yadav

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

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Posterior midline laminectomy is associated with risks of postoperative instability, spinal deformity, extensive bilateral subperiosteal muscle stripping, partial or total facetectomy especially in foraminal tumor extension, increased cerebrospinal fluid leakage, and wound infection. Minimally invasive approaches with the help of a microscope or endoscope using hemilaminectomy have been found to be safe and effective. We report our initial experience of 18 patients using the endoscopic technique. A retrospective study of intradural extramedullary tumors extending up to two vertebral levels was studied. Pre- and postoperative clinical status, magnetic resonance imaging was done in all patients. The Destandau technique was used, and resection of ipsilateral lamina, medial part of the facet joint, base of the spinous process, and undercutting of the opposite lamina was performed. Dura repair was done using an endoscopic technique. Fibrin glue was used to reinforce repair in the later part of the study. The sagittal and axial diameter of tumor ranged from 21 to 41 mm and 12 to 18 mm, respectively. There were four cervical, two cervicothoracic, five thoracic, three thoracolumbar, and four lumbar tumors, respectively. All 18 patients improved after total excision of tumor. Average duration of surgery and blood loss was 140 minutes and 60 mL, respectively. Postoperative stay and follow-up ranged from 3 to 7 days and 9 to 24 months, respectively. Although the study is limited by the small number of patients with a short follow-up and is a technically demanding procedure, endoscopic management of intradural extramedullary tumors was an effective and safe alternative technique to microsurgery in such patients.

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The use of minimally invasive approaches to resect intradural extramedullary spinal cord tumors

Cited by 14 publications

References 27 publications

Functional Outcome of Intradural Extramedullary Spinal Tumors after Surgical Resection

Functional Outcome of Intradural Extramedullary Spinal Tumors after Surgical Resection

Functional Outcomes following Surgical Management of Intradural Extramedullary Spinal Cord Tumors

Endoscopic Management of Spinal Intradural Extramedullary Tumors

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