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Complete Excision of Intradural-Extraforaminal Spinal Tumors Using a Minimally Invasive 2-Incision Technique With

Umesh Srikantha¹, Akshay Hari, Yadhu K Lokanath

¹Department of Neurosurgery, Aster CMI Hospital, Bengaluru, Karnataka, India.

Clinical Spine Surgery

|July 23, 2020

Summary

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A novel minimally invasive surgical technique uses two incisions to remove large spinal tumors, avoiding instability and reducing tissue damage. This approach offers a less invasive alternative for complete tumor excision.

Area of Science:

Neurosurgery
Spinal Surgery
Oncology

Background:

Intradural-extramedullary spinal tumors can be large and complex, often requiring extensive surgery.
Traditional open approaches involve significant muscle dissection and bone removal, potentially leading to spinal instability.
Minimally invasive techniques aim to reduce surgical trauma and preserve spinal integrity.

Purpose of the Study:

To describe and evaluate a novel two-incision, minimally invasive surgical technique for complete resection of large intradural-extramedullary spinal tumors.
To demonstrate the versatility of this technique in different spinal regions.

Main Methods:

A novel surgical approach utilizing two incisions: one paramedian and one far-lateral.
Employing facet-sparing corridors to access both intraspinal and extraspinal tumor components.

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Minimally invasive tubular retractors to minimize muscle stripping and bony resection.

Main Results:

Complete gross total resection was achieved in all three presented cases.
The technique successfully addressed tumors in both cervical and thoracolumbar regions.
The described approach minimized muscle dissection and bony resection compared to traditional methods.

Conclusions:

This novel two-incision minimally invasive technique provides a viable and effective option for complete resection of large intradural-extramedullary spinal tumors.
The approach obviates the need for spinal stabilization by preserving spinal structures.
The technique is versatile and applicable to various spinal locations, including cervical and thoracolumbar regions.