One-stage microsurgical treatment of dumbbell tumors / 中国微创外科杂志

ABSTRACT

Objective To summarize our experience in microsurgical treatment of dumbbell tumors. Methods The clinical features,surgical approaches,operative techniques and surgical results of 21 cases of dumbbell tumors were analyzed retrospectively.Four surgical approaches were adopted according to the size and location of tumors,including,posterior midline approach(in 7 cases),modified far lateral approach(in 5 cases),posterior midline supplied by anterior cervical approach(in 2 cases)and paramidline approach(in 7 cases). Results In this series,10 cases of tumors were situated in the cervical,6 in thoracic,4 in lumbar and 1 in sacral segment of the spine.Total removal were achieved in 95% (20/21),and subtotal removal in 5%(1/21).Postoperative pathological diagnosis revealed 15 neurinomas,5 spinal meningiomas and 1 metastatic adenocarcinoma.14 cases of meningiomas and 1 metastatic adenocarcinoma were followed up for 1 to 48 months.11 of the 14 patients recovered completely,with 3 of them living daily life independently,4 maintainly radical hypoesthesia,and one having decubital ulcer unhealed.No postoperative malformation and dysfunction of the disposed spine occurred in these patients.Magnetic resonance imaging scans in 11 of the 14 follow-up cases revealed no tumor recurrence,of which inhanced MRI scans were performed in 8 cases. Conclusions dumbbell tumors should be treated by one-stage operation.Microsurgical technique could improve the rate of total removal,and decrease postoperative complications.