Unilateral, multilevel, interlaminar fenestration in the removal of a multisegment cervical intramedullary ependymoma

Xie, Tianhao; Qian, Jun; Wu, Xiaojun; Lu, Yao; Hu, Guohan; Luo, Chun

doi:10.1016/j.spinee.2013.02.048

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…Taking these complications into consideration, some researchers have suggested fusing the spine, primarily at the time of laminectomy, to reduce the risk of spinal instability (15), but this additional procedure would increase the operative time, complications, and sequelae, and result in additional costs to patients, which is undesirable. Other procedures, like laminoplasty and interlaminar fenestration, have been described by different authors (8,21), but these procedures are also not free from complications. The concept of minimally invasive spine surgery evolved to avoid complications, and Yasargil et al were the first to use unilateral hemilaminectomy for the excision of intradural tumors in 1991 (18).…”

Section: █ Discussionmentioning

confidence: 99%

Unilateral hemilaminectomy for excision of intradural extramedullary tumours : a beginners’ challenges

Kumar

Upadhyay²

2019

Turkish Neurosurgery

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AIM:To analyze retrospectively our experience of unilateral hemilaminectomy in intradural extramedullary (IDEM) tumors. MATERIAL and METHODS:This study included 28 patients with IDEM tumors who underwent unilateral hemilaminectomies during the period 2011-2016. The preoperative clinicoradiological data, intraoperative findings, and postoperative outcomes were analyzed using a Microsoft Excel database. RESULTS:The mean age of the patients was 49.14±12.23 years, and the average duration of symptoms was 11.82 weeks. The tumor distribution in the spine was as follows: cervical spine (14.2%), cervicodorsal spine (3.6%), dorsal spine (39.3%), dorsolumbar spine (10.7%), and lumbar spine (32.1%). Twenty patients (71%) underwent two-level laminectomies, and three-level laminectomies were performed on eight patients (29%). The mean operative time was 4 hours and 40 minutes. CONCLUSION:Unilateral hemilaminectomy is a safe, minimally invasive procedure for the excision of IDEM tumors. Beginners may face difficulties with this procedure and should ideally take more time than with a conventional total laminectomy because of the narrow operating corridor. As more experience is gained, this procedure will become easier in selected cases.

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Section: █ Discussionmentioning

confidence: 99%

Unilateral hemilaminectomy for excision of intradural extramedullary tumours : a beginners’ challenges

Kumar

Upadhyay²

2019

Turkish Neurosurgery

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“…While the increasing implementation of minimally invasive surgical techniques globally over the past decades has reflected the importance of reducing surgical trauma, there is no clinically robust clinical evidence for minimally invasive surgery for spinal lesions or tumors. No randomized controlled trials comparing procedures have been published; the nature of these lesions would make such a study difficult to coordinate regardless of whether it was in a single center or multi‐institutional setting.…”

Section: Discussionmentioning

confidence: 99%

“…Such methods have demonstrated positive outcomes. However, apart from a large cohort study by Koch et al and some single case reports, little data is available on the efficacy of this procedure and how it compares with other modes of lesion resection 23,24 .…”

Section: Technical Requirements Of the Limited Approachmentioning

confidence: 99%

Unilateral Hemilaminectomy for Intradural Lesions

Mobbs

Maharaj

Phan

et al. 2015

Orthopaedic Surgery

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“…All patients underwent 3.0-T MRI examinations; lesions were observed in the cervical cord (86 patients), thoracic spine (18), conus medullaris (5), and filum terminale (3). The lesions involved 1-2 segments (12 patients), 3-4 segments (58), 5-6 segments (26), or ≥7 segments (16) (Figures 1-3).…”

Section: Imaging Findingsmentioning

confidence: 99%

Fluorescein Sodium Use during Spinal Ependymoma Resection

Sun

Yuan

Sun³

et al. 2017

Translational Neuroscience and Clinics

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Spinal ependymomas (SEs) are common adult intramedullary tumors; however, determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium (FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS (3-4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging (MRI) at 10 days and 3 months after surgical recovery; McCormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92% (103/112). Ninetyfour patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in 18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function (85.8% (91/106)) and movement (84.3% (86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7% (16/24). The McCormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade (I-IV), compared with preoperative classifications (each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.

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Unilateral, multilevel, interlaminar fenestration in the removal of a multisegment cervical intramedullary ependymoma

Cited by 10 publications

References 27 publications

Unilateral hemilaminectomy for excision of intradural extramedullary tumours : a beginners’ challenges

Unilateral hemilaminectomy for excision of intradural extramedullary tumours : a beginners’ challenges

Unilateral Hemilaminectomy for Intradural Lesions

Fluorescein Sodium Use during Spinal Ependymoma Resection

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