RESUMEN
We report our experience with the removal of ventral intradural spinal tumors through a posterior approach with the assistance of an endoscope. The endoscope allowed us to remove the tumor with minimal retraction of the spinal cord and to inspect for involvement of structures that were difficult to visualize with the microscope. Moreover, it obviated the use of a more involved anterior approach. This is the second report of the utilization of the endoscope for removal of intradural spinal cord tumors. Our data are discussed in the context of prior reported morphometric studies involving the spinal cord and expand the indications for the endoscope.
Asunto(s)
Duramadre/cirugía , Endoscopía/métodos , Melanoma/cirugía , Meningioma/cirugía , Neoplasias de la Médula Espinal/cirugía , Médula Espinal/patología , Médula Espinal/cirugía , Adulto , Anciano de 80 o más Años , Vértebras Cervicales/anatomía & histología , Vértebras Cervicales/cirugía , Duramadre/anatomía & histología , Femenino , Humanos , Laminectomía/métodos , Imagen por Resonancia Magnética , Masculino , Melanoma/patología , Melanoma/fisiopatología , Meningioma/patología , Meningioma/fisiopatología , Procedimientos Neuroquirúrgicos/instrumentación , Procedimientos Neuroquirúrgicos/métodos , Médula Espinal/fisiopatología , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/patología , Compresión de la Médula Espinal/fisiopatología , Neoplasias de la Médula Espinal/patología , Neoplasias de la Médula Espinal/fisiopatología , Vértebras Torácicas/anatomía & histología , Vértebras Torácicas/cirugía , Resultado del TratamientoRESUMEN
INTRODUCTION: At the University of Cincinnati, we have developed a shared-resource magnetic resonance operating suite that facilitates performance of both neurosurgical and diagnostic procedures in a single unit. METHODS: The shared-resource magnetic resonance operating suite utilizes a Hitachi AIRIS II, 0.3-T, vertical field, open MRI unit located in the MROR. This magnet can be used for both diagnostic and interventional procedures. The addition of a rotating-operating table permits neurosurgical procedures to be performed outside of the 5-G line using standard neurosurgical equipment and operating microscopes. RESULTS: We review our results with the shared-resource magnetic resonance operating room including the tabulated results from 30 transsphenoidal procedures and 63 glioma procedures. In addition, 2832 diagnostic procedures have been performed in the first 4 years of use. CONCLUSION: The shared-resource intraoperative MRI facility produces high-quality intraoperative imaging studies, equal to those of high-resolution magnets, and is valuable in enabling the surgeon to achieve the planned degree of resection of glioma and pituitary tumors. The ability to perform diagnostic procedures in a shared unit has been a cost-effective solution for our institution.