Surgical treatment and outcomes of intramedullary tumors by minimally invasive approach

Yüce, İsmail; Kahyaoğlu, Okan; Çavuşoğlu, Halit; Ataseven, Müzeyyen; Aydın, Yunus

doi:10.1016/j.jocn.2021.01.001

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Perez-Cruet et al ( 16 ) previously found that an increasing number of experimental and clinical studies had established a strong correlation between vertebral column stability and the vertebral lamina's decompression degree. As a result, in clinical settings and evidence-based studies, the UHMV procedure has largely superseded total laminectomy ( 5 , 17 – 20 ). The disadvantage of hemilaminectomy is that the surgical area between the spinous process and the ipsilateral facet joint is small, and microscope-based visualization is limited by a small depth of field, tubular vision, and inadequate illumination of deeper sites.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Neuroendoscopic and Microscopic Surgery for Unilateral Hemilaminectomy: Experience of a Single Institution

Zeng

Jiang

et al. 2022

Front. Surg.

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ObjectiveThis study was designed to compare the safety and efficacy of unilateral hemilaminectomy conducted under complete neuroendoscopic visualization (UHNV) relative to unilateral hemilaminectomy under total microscopic visualization (UHMV) for the treatment of patients diagnosed with intraspinal tumors.MethodsIn total, 41 patients undergoing intraspinal tumor resection at Northern Jiangsu People's Hospital were included in this study, including 20 and 21 patients in the UHNV and UHMV groups, respectively. Intraoperative parameters including incision length, operative duration, number of vertebral laminae removed and intraoperative blood loss, as well as indicators of curative efficacy such as total tumor resection rates and postoperative symptom improvement rates, and safety indicators including complication rates, recurrence rates, spinal deformity rates, spinal instability incidence, and length of stay (LOS), were compared between the two groups.ResultsIn contrast to the UHMV group, patients in the UHNV group had a significantly shorter incision length and decreased intraoperative blood loss (P < 0.05), while the operative duration (P > 0.05) showed no statistical difference. Although the postoperative improvement and total tumor resection rates were enhanced, the difference was not statistically significant (P > 0.05). In comparison, the bedridden time and length of stay (LOS) were significantly shortened (P < 0.05) in the UHNV group. However, there were no significant differences in recurrence, incidence of complications, spinal deformity, and spinal instability (P > 0.05).ConclusionCollectively, our findings indicate that UHNV is not inferior to the UHMV approach. Moreover, due to its safe and minimally invasive nature, UHNV represents a promising alternative to UHMV as a treatment for patients with intradural extramedullary tumors.

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Section: Discussionmentioning

confidence: 99%

Comparison of Neuroendoscopic and Microscopic Surgery for Unilateral Hemilaminectomy: Experience of a Single Institution

Zeng

Jiang

et al. 2022

Front. Surg.

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“…Surgical resection of IMSC tumors is often indicated to alleviate the progression of neurological symptoms, obtain a histological diagnosis, and guide the treatment strategy. It is associated with better prognosis and survival rates [ 1 , 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are few reports of MIS resection of intramedullary tumors. Yüce et al [ 1 ] described a midline open approach, with an open unilateral subperiosteal muscle dissection and hemilaminectomy at the cervical and thoracic levels. This unilateral surgical approach still allowed for a bilateral exposure of the thecal sac.…”

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Approach for Complete Resection of a Cervical Intramedullary Tumor via a Dorsal Root Entry Zone Using Fixed Tubular Retractor

Tarabay¹,

Gennari²,

Boubez³

et al. 2022

Cureus

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We describe the surgical aspects of the resection of a large 2cm intramedullary ependymoma at the C6-7 level associated with an extensive syrinx using a unilateral minimally invasive approach through a fixed tubular retractor. A gross total resection was achieved. Total operative time was 5 hours. Estimated blood loss was less than 100 cc. Postoperative evolution was favorable, with the improvement of the patient's neurological status. There was no cerebrospinal fluid (CSF) fistula. Hospital stay was four days. All narcotics were stopped on day 1 after surgery. Post-operative MRI showed no residual tumor. At the six-month followup, there was continued improvement in his neurological status. Scoliosis films did not reveal any cervicothoracic kyphosis.

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“…MIS management of intramedullary tumors is limited to mini open approach with hemilaminectomy and laminotomy for which GTR may still be achieved with benefit of smaller incision and preservation of vertebral stability [41,42]. A retrospective study by Kahyaoglu et al, who treated 168 intramedullary tumors via hemilaminectomy, showed that neurologic complications increased when intramedullary tumors extended greater than three spinal segments, especially in thoracic spine compared with the cervical spine [43].…”

Section: Expanding Role Of Miss Management Of Spine Tumorsmentioning

confidence: 99%

Minimally Invasive Treatment of Spinal Metastasis

Mong¹,

Fahim²

2022

Minimally Invasive Spine Surgery - Advances and Innovations

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Advancements in the treatment of systemic cancer have improved life expectancy in cancer patients and consequently the incidence of spinal metastasis. Traditionally, open spinal approaches combined with cEBRT (conventional external beam radiation therapy) allowed for local tumor control as well as stabilization and decompression of the spine and neural elements, but these larger operations can be fraught with one complications and delayed healing as well as additional morbidity. Recently, minimally invasive spine techniques are becoming increasingly popular in the treatment of spinal metastasis for many reasons, including smaller incisions with less perioperative complications and potential for expedited time to radiation therapy. These techniques include kyphoplasty with radiofrequency ablation, percutaneous stabilization, laminectomy, and epidural tumor resection through tubular retractors, as well as minimally invasive corpectomy. These techniques combined with highly conformal stereotactic radiosurgery have led to the advent of separation surgery, which allows for decompression of neural elements while creating space between neural elements and the tumor so adequate radiation may be delivered, improving local tumor control. The versatility of these minimally invasive techniques has significantly improved the modern management of metastatic disease of the spine by protecting and restoring the patient’s quality of life while allowing them to quickly resume radiation and systemic treatment.

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Surgical treatment and outcomes of intramedullary tumors by minimally invasive approach

Cited by 9 publications

References 31 publications

Comparison of Neuroendoscopic and Microscopic Surgery for Unilateral Hemilaminectomy: Experience of a Single Institution

Comparison of Neuroendoscopic and Microscopic Surgery for Unilateral Hemilaminectomy: Experience of a Single Institution

Minimally Invasive Approach for Complete Resection of a Cervical Intramedullary Tumor via a Dorsal Root Entry Zone Using Fixed Tubular Retractor

Minimally Invasive Treatment of Spinal Metastasis

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