Skip to main content
Erschienen in: European Spine Journal 12/2016

01.07.2016 | Ideas and Technical Innovations

Minimally invasive resection of extradural dumbbell tumors of thoracic spine: surgical techniques and literature review

verfasst von: Chunbo Li, Yun Ye, Yutong Gu, Jian Dong

Erschienen in: European Spine Journal | Ausgabe 12/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Dumbbell-shaped thoracic tumors represent a distinct type of tumor and involve in both the spinal canal and the posterior thoracic cavity. Successful treatment for the tumors depends on gross total resection (GTR) via an open laminectomy and facetectomy or transthoracic transpleural approach. In this case series, we report our experiments with minimally invasive method for the removal of extradural dumbbell thoracic tumor and present related literature review.

Methods

We retrospectively reviewed two patients with dumbbell-shaped thoracic tumors who underwent minimally invasive resection and unilateral transforaminal thoracic intervertebral fusion (TTIF) through unilateral paraspinal muscle approachwith a spotlight expandable tubular retractor. Clinical data, tumor characteristics, and outcomes were analyzed.

Results

Two patients underwent successful minimally invasive treatment of their spinal neoplasms. There were no procedure-related complications. The efficacy in terms of neurological recovery, pain improvement and operative variables (length of incision, operative duration, blood loss, and hospital stay) was better when compared with prior published studies. Postoperative CT image demonstrated complete resection of dumbbell tumor in the patients. The solid fusion was obtained after 3 months follow-up and there was no failure of internal fixation.

Conclusion

If the medial border of intracanal component of extradural dumbbell tumor is near the midline of canal and the pedicles of adjacent vertebrae to tumor are intact, minimally invasive resection of tumor through unilateral paraspinal muscle approach combined with unilateral TTIF is good choice.
Literatur
1.
Zurück zum Zitat Celli P, Trillo G, Ferrante L (2005) Extrathecal intraradicular nerve sheath tumor. J Neurosurg Spine 3:1–11CrossRefPubMed Celli P, Trillo G, Ferrante L (2005) Extrathecal intraradicular nerve sheath tumor. J Neurosurg Spine 3:1–11CrossRefPubMed
4.
Zurück zum Zitat Hioki A, Miyamoto K, Hirose Y, Kito Y, Fushimi K, Shimizu K (2012) Cervical symmetric dumbbell ganglinoeuromas causing severe paresis. Asian Spine J 8:74–78CrossRef Hioki A, Miyamoto K, Hirose Y, Kito Y, Fushimi K, Shimizu K (2012) Cervical symmetric dumbbell ganglinoeuromas causing severe paresis. Asian Spine J 8:74–78CrossRef
5.
Zurück zum Zitat Gu BS, Park JH, Roh SW, Jeon SR, Jang JW, Hyun SJ, Rhim SC (2014) Surgical strategies for removal of intra- and extraforaminal dumbbell-shaped schwannomas in the subaxial cervical spine. Eur Spine J. doi:10.1007/s00586-014-3458-9 Gu BS, Park JH, Roh SW, Jeon SR, Jang JW, Hyun SJ, Rhim SC (2014) Surgical strategies for removal of intra- and extraforaminal dumbbell-shaped schwannomas in the subaxial cervical spine. Eur Spine J. doi:10.​1007/​s00586-014-3458-9
9.
Zurück zum Zitat Gu Y, Zhang F, Jiang X, Jia L, McGuire R (2013) Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty in the surgical treatment of thoracolumbar osteoporosis fracture. J Neurosurg Spine 18:634–640. doi:10.3171/2013.3.SPINE12827 CrossRefPubMed Gu Y, Zhang F, Jiang X, Jia L, McGuire R (2013) Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty in the surgical treatment of thoracolumbar osteoporosis fracture. J Neurosurg Spine 18:634–640. doi:10.​3171/​2013.​3.​SPINE12827 CrossRefPubMed
10.
Zurück zum Zitat Association ASI (2003) Reference manual of the international standards for neurological classification of spinal cord injury. American Spinal Injury Association, Chicago Association ASI (2003) Reference manual of the international standards for neurological classification of spinal cord injury. American Spinal Injury Association, Chicago
12.
Zurück zum Zitat Gu R, Liu JB, Xia P, Li C, Liu GY, Wang JC (2014) Evaluation of hemilaminectomy use in microsurgical resection of intradural extramedullary tumors. Oncol Lett. doi:10.3892/ol.2014.1949 Gu R, Liu JB, Xia P, Li C, Liu GY, Wang JC (2014) Evaluation of hemilaminectomy use in microsurgical resection of intradural extramedullary tumors. Oncol Lett. doi:10.​3892/​ol.​2014.​1949
14.
Zurück zum Zitat Masahiro K, Yutaka I, Daisuke S, Nahoko M, Masatsugu K, Hajime H (2005) Treatment of thoracolumbar fractures with vertebroplasty in combination with posterior instrumentation. Neurosurg Q 15:181–185CrossRef Masahiro K, Yutaka I, Daisuke S, Nahoko M, Masatsugu K, Hajime H (2005) Treatment of thoracolumbar fractures with vertebroplasty in combination with posterior instrumentation. Neurosurg Q 15:181–185CrossRef
15.
Zurück zum Zitat Ohya J, Miyoshi K, Kitagawa T, Sato Y, Maehara T, Mikami Y (2015) Combined video-assisted thoracic surgery and posterior spinal surgery for the treatment of dumbbell tumor of the first thoracic nerve root. Asian Spine J 9:595–599CrossRefPubMedPubMedCentral Ohya J, Miyoshi K, Kitagawa T, Sato Y, Maehara T, Mikami Y (2015) Combined video-assisted thoracic surgery and posterior spinal surgery for the treatment of dumbbell tumor of the first thoracic nerve root. Asian Spine J 9:595–599CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Tanaka T, Kato N, Aoki K, Nakamura A, Watanabe M, Tochigi S, Marushima H, Akiba T, Hasegawa Y, Abe T (2012) Combined unilateral hemilaminectomy and thoracoscopic resection of the dumbbell-shaped thoracic neurinoma: a case report. Case Rep Neurol Med 2012:517563. doi:10.1155/2012/517563 PubMedPubMedCentral Tanaka T, Kato N, Aoki K, Nakamura A, Watanabe M, Tochigi S, Marushima H, Akiba T, Hasegawa Y, Abe T (2012) Combined unilateral hemilaminectomy and thoracoscopic resection of the dumbbell-shaped thoracic neurinoma: a case report. Case Rep Neurol Med 2012:517563. doi:10.​1155/​2012/​517563 PubMedPubMedCentral
17.
Zurück zum Zitat Haji F, Cenic A, Crevier L, Murty N, Reddy K (2011) Minimally invasive approach for the resection of spinal neoplasm. Spine 36:1018–1026CrossRef Haji F, Cenic A, Crevier L, Murty N, Reddy K (2011) Minimally invasive approach for the resection of spinal neoplasm. Spine 36:1018–1026CrossRef
19.
Zurück zum Zitat Tredway T, Santiago P, Hrubes M, Song J, Christie S, Fessler R (2006) Minimally invasive resection of intradural–extramedullary spinal neoplasms. Neurosurgery 58:52–58. doi:10.1016/j.joca.2014.02.004 Tredway T, Santiago P, Hrubes M, Song J, Christie S, Fessler R (2006) Minimally invasive resection of intradural–extramedullary spinal neoplasms. Neurosurgery 58:52–58. doi:10.​1016/​j.​joca.​2014.​02.​004
20.
Zurück zum Zitat Goncalves VM, Santiago B, Ferreira VC, Cunha ESM (2014) Minimally invasive resection of an extradural far lateral lumbar schwannoma with zygapophyseal joint sparing: surgical nuances and literature review. Case Rep Med 2014:739862. doi:10.1155/2014/739862 PubMedPubMedCentral Goncalves VM, Santiago B, Ferreira VC, Cunha ESM (2014) Minimally invasive resection of an extradural far lateral lumbar schwannoma with zygapophyseal joint sparing: surgical nuances and literature review. Case Rep Med 2014:739862. doi:10.​1155/​2014/​739862 PubMedPubMedCentral
22.
Zurück zum Zitat Stillerman CB, Chen TC, Day JD, Couldwell WT, Weiss MH (1995) The transfacet pedicle-sparing approach for thoracic disc removal: cadaveric morphometric analysis and preliminary clinical experience. J Neurosurg 1995:971–976CrossRef Stillerman CB, Chen TC, Day JD, Couldwell WT, Weiss MH (1995) The transfacet pedicle-sparing approach for thoracic disc removal: cadaveric morphometric analysis and preliminary clinical experience. J Neurosurg 1995:971–976CrossRef
23.
Zurück zum Zitat Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR (2010) Early experience treating thoracic disc herniations using a modified transfacet pedicle-sparing decompression and fusion. J Neurosurg Spine 2010:221–231. doi:10.3171/2009.9.SPINE09476 CrossRef Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR (2010) Early experience treating thoracic disc herniations using a modified transfacet pedicle-sparing decompression and fusion. J Neurosurg Spine 2010:221–231. doi:10.​3171/​2009.​9.​SPINE09476 CrossRef
Metadaten
Titel
Minimally invasive resection of extradural dumbbell tumors of thoracic spine: surgical techniques and literature review
verfasst von
Chunbo Li
Yun Ye
Yutong Gu
Jian Dong
Publikationsdatum
01.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 12/2016
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4677-z

Weitere Artikel der Ausgabe 12/2016

European Spine Journal 12/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders scheint das auf weibliche Kranke zuzutreffen, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.