| Posterior Hemilaminectomy Approach to Anterolaterally Located Intradural Extramedullary Spinal Cord Tumors |
|
Jae-Whan Cha, M.D., Jong-Sun Lee, M.D. and Ho-Gyun Ha, M.D. |
|
Department of Neurosurgery, Eulji University School of Medicine, Daejeon, Korea |
| 전측방에 위치한 경막내 수외 척수종양에 대한 후방 일측성 추궁절제 접근법 |
|
차재환, 이종선, 하호균 |
|
을지대학교 의과대학 신경외과학교실 |
|
|
|
|
| Abstract |
Objective
s: Conventional anterior corpectomy or posterior laminectomy approaches to spinal intradural extramedullary (IDEM) tumors have disadvantages of higher degree violation of spinal integrity or greater risk of spinal cord damage due to cord retraction, especially when the tumors are located anterior or lateral to spinal cord. To minimize invasiveness and to preserve spinal structure as much as possible, the author adopted the endoscope to the modified hemilaminectomy approach.
Materials and methods
Since 2000, eight patients with anterolaterally located spinal IDEM tumors had been operated with the modified hemilaminectomy approach, 3 cervical and 5 thoracic IDEM tumors. Surgery was performed in the lateral position. Paramedian skin incison and unilateral laminectomy was made, sparing facet joint and interspinous ligament. Through this hemilamnectomy window, dura was opened and tumor was resected microsurgically. As blind corner of microscopic view, foraminal extension of tumor and ventral surface of spinal cord could be easily observed with endoscope, total removal of tumor was possible with minimal cord manipulation.
Results
Gross total removal of IDEM tumor was achieved in all 8 cases. The patients were mobilized the following day after surgery without the use of any external support. All the patients showed neurological improvement. During follow-up evaluation(12節48 months), none of the patients showed tumor recurrence, spinal deformity or spinal instability.
Conclusion
This approach allows direct visualization of the ventral and dorsal boundaries of the tumor with minimal manipulation of the spinal cord. Main advantage of this approach is preservation of spinal stability. The authors suggest that this approach offers significant advantages for the treatment of anterolaterally located IDEM cervical and thoracic tumors, and should be given priority over conventional approaches.
|
| Keywords:
Spinal cord tumors, Hemilaminectomy, Endoscopy |
|
PDF Links
Full text via DOI
Download Citation
