Minimally Invasive Surgical Approach for Spinal Canal Tumors—Technique Description and Experience from a Reference Center

• 作者: Carlos Lindado Juan Acevedo Juan Carlos Perez Juan Gomez Juan Sardi Manuel Giraldo-Grueso María Camila Villegas Miguel Berbeo Oscar Feo Lee Oscar Zorro Pablo Harker Roberto Diaz Santiago Gutierrez
• 来源期刊: 癌症治疗(英文)
• 学科: 医学
• 关键词: SPINAL TUMORS MINIMALLY INVASIVE SPINE Surgery Surgical TECHNIQUE
• 年，卷（期）: azzlyw_2017,（3）
• 页码范围: 268-277
• 页数: 10页
• 分类号: R73

摘要

Background: Spinal canal tumors are difficult to diagnose and treat. The traditional surgical approaches for attempting a complete excision of these lesions frequently involve big incisions and tissue dissection with high risk of postop instability and cerebrospinal fluid leakage. Also, there is a risk of neurological worsening, sometimes irreversible. Methods: We present our experience in a patient series with spinal canal tumors and describe the surgical approach with minimally invasive techniques (MIS). All of them were performed by the Neurosurgery team of the Hospital Universitario San Ignacio during the period of 2011-2016. Results: We reviewed forty patients with spinal canal tumors surgically treated with MIS techniques. 15 patients (37.5%) had Meningioma diagnosis (complete resection in 11 (73.3%), subtotal in 3 (20%) and biopsy in one patient), 10 patients (25%) with Schwannomas reached complete resection in 70% and subtotal in 30%. 5 patients had spinal cord metastasis, with complete resection in 4 patients (80%) and subtotal in 1 (20%). Other included ependymoma, astrocytoma, and miscellaneous. No patient has had cerebrospinal fluid leakage and no postoperative fusion has been required. Conclusions: The minimally invasive approach allowed complete tumors removal in a high number of patients and good postoperative results. These findings are similar and in some cases, better than the reported with traditional techniques. This MIS technique provides encouraging results. It requires a wide learning curve and a high degree of surgical experience.