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World Neurosurg ; 133: e97-e104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31505279

RESUMO

BACKGROUND: Intraspinal tumors are 10 to 15 times less common than brain tumors. The midline approach with extensive laminectomies represents the current gold-standard for resection, causing instability, muscle damage, and kyphosis among other well-known complications. Minimally invasive series reported their results using retractor-based systems. We analyzed a patient series treated with a non-expansile tubular approach, describing the technique, grade of resection, and clinical outcomes. METHODS: A series of consecutive cases operated between 2016 and October 2018 were analyzed retrospectively. The database included age, sex, clinical presentation, intraspinal location (intra/extradural), number of laminotomies, grade of resection, surgical time, bleeding, and follow-up. The initial and follow-up clinical condition was analyzed using the Frankel scale. RESULTS: A total of 13 patients underwent surgery: 3 intraspinal/extradural (23%), 8 intradural/extramedullary (61.5%), and 2 intramedullary tumors (15.3%); these were classified as 5 meningiomas (38.4%), 4 neurofibromas (30.7%), 2 schwannomas (15.3%), 1 hemangioblastoma (7.6%), and 1 astrocytoma (7.6%). Eleven (84.61%) patients had complete motor improvement, 1 patient had partial improvement, and 1 patient had no improvement (7.6% each). An 18-mm working channel tube was used for extramedullary lesions and 20-mm tubes for intramedullary injuries. Total tumor resection was achieved in 11 patients (84.6%) and subtotal in 2 patients (15.38%) corresponding to intramedullary tumors. CONCLUSIONS: Although this study consisted of a small series, we have shown the possibility of resecting intraspinal tumors (some intradural-intramedullary) with non-expansile tubes in a safe and effective way with no complications. Most of the patients had complete neurological improvement at the end of follow-up.


Assuntos
Descompressão Cirúrgica/métodos , Fixadores Internos , Microcirurgia/métodos , Neoplasias da Medula Espinal/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Idoso , Descompressão Cirúrgica/instrumentação , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Microcirurgia/instrumentação , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neurofibroma/diagnóstico por imagem , Neurofibroma/cirurgia , Estudos Retrospectivos , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Adulto Jovem
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