Reisch, R;
Koechlin, NO;
Marcus, HJ;
(2016)
Minimally invasive keyhole approaches in spinal intradural tumor surgery: report of two cases and conceptual considerations.
Journal of Neurosurgical Sciences
, 60
(3)
pp. 392-397.
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Abstract
Despite their histologically benign nature, intradural tumors may become symptomatic by virtue of their space-occupying effect, causing severe neurological deficits. The gold standard treatment is total excision of the lesion; however, extended dorsal and dorsolateral approaches may cause late complications due to iatrogenic destruction of the posterolateral elements of the spine. In this article, Axel Perneczky’s concept of minimally invasive spinal tumor surgery is described. Two illustrative cases demonstrate the feasibility and safety of keyhole fenestrations exposing the spinal canal. The first case is a 67-year-old woman with a 1-year history of severe back pain, right thoracic radiculopathy, and slight gait disturbance. Neuroimaging revealed a right-sided combined intradural-extradural spinal schwannoma at T11/12 , with compression of the spinal cord and lateral extension through the intervertebral foramen. The tumor was successfully removed through a contralateral left-sided hemilaminectomy. The second case is a 38-year-old man with progressive spinal ataxia caused by an intramedullary C6-8 ependymoma. Here, bi-segmental interlaminar fenestrations were performed, allowing safe and minimally invasive tumor resection. In both cases, postoperative imaging confirmed complete tumor removal and both patients showed neither neurological deterioration, nor vertebral instability or pain syndromes.
| Type: | Article |
|---|---|
| Title: | Minimally invasive keyhole approaches in spinal intradural tumor surgery: report of two cases and conceptual considerations |
| Location: | Italy |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | https://www.minervamedica.it/en/journals/neurosurg... |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Contralateral hemilaminectomy, Interlaminal fenestration, Keyhole spinal surgery, Preoperative planning, Spinal schwannoma, Spinal ependymoma |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10059179 |
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