Chunbo Li1, Yun Ye2, Yutong Gu3, Jian Dong1. 1. Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai, 180 Fenglin Road, Shanghai, 200032, China. 2. Department of Orthopaedics, Zhenjiang Hospital of Traditional Chinese and Western Medicine, Zhenjiang, 212000, Jiangsu, China. 3. Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai, 180 Fenglin Road, Shanghai, 200032, China. 447574313@qq.com.
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.
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.
Authors: Kevin Phan; Khushdeep S Vig; Yam Ting Ho; Awais K Hussain; John Di Capua; Jun S Kim; Samuel J W White; Nathan J Lee; Parth Kothari; Samuel K Cho Journal: Global Spine J Date: 2018-08-13
Authors: Kevin Phan; Zoe B Cheung; Khushdeep S Vig; Awais K Hussain; Mauricio C Lima; Jun S Kim; John Di Capua; Samuel K Cho Journal: Global Spine J Date: 2017-12-10