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DOI: https://doi.org/10.14245/ns.2244152.076    [Accepted]
Published online May 16, 2022.
Comparison of the Clinical Efficacy of Transforaminal Endoscopy and Microtubular Technology for the Treatment of Lumbar Dumbbell-Shaped Tumors
Rui Wang, Ze Yan Liang, Yan Chen, Chun Mei Chen 
Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
Corresponding Author:  Chun Mei Chen
Fax: -   Email: cmchen2009@sina.com
Received: February 22, 2022   Revised: April 13, 2022   Accepted: April 17, 2022
Abstract
Objective
To analyze differences in feasibility and efficacy between the paravertebral approach and micro-tubular tumorectomy (PAMT) or percutaneous transforaminal endoscopic tumorectomy (PTET) for the treatment of lumbar dumbbell-shaped tumors.
Methods
Clinical data of dumbbell-shaped lumbar tumors in patients treated with PAMT or PTET in our hospital between June 2015 and November 2020 were retrospectively analyzed. The gross total resection (GTR) rate, operation time, estimated blood loss, postoperative hospital stay (PHS), postoperative neurological function, and spinal stability were compared between the two surgical methods. Neurological improvement was assessed using the pain visual analog scale (VAS) and the Japanese Orthopaedic Association (JOA) score.
Results
Fifteen cases of GTR (93.8%) and one case of subtotal resection were included in the PTET group, whilst all 18 patients in the PAMT group achieved GTR. There was no significant difference in the GTR rate, operation time, and PHS between the PAMT and PTET groups. The estimated blood loss was significantly lower in the PTET group than in the PAMT group. At the last follow-up, there was no significant difference in the VAS or JOA scores between PTET and PAMT. No tumor recurrence or spinal instability was observed in either group during the follow-up period.
Conclusion
Both PAMT and PTET can achieve Eden type III-IV lumbar one-stage tumor resection without additional spinal internal fixation due to reduced muscle, ligament, and facet joint damage. No lumbar instability and tumor recurrence occurred, and neurological function was improved.
Keywords: lumbar spine, Dumbbell-shaped tumor, Eden grade, Microtubular technique, Spinal endoscopy, Gross total resection


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