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Author Spotlight: Unveiling the Potential of TUBE Technique in Spinal Surgery
Published on: November 17, 2023
Pure endoscopic minimally invasive surgery with a non‑expandable tubular retractor for intradural extramedullary
Gang Zhang1,2, Bin Jia1, Pan Wang1,2
1Department of Neurosurgery, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 401147, P.R. China.
Abstract:
Minimally invasive spinal surgery (MISS) for intradural extramedullary (IDEM) spinal tumors is a safe and effective surgical strategy. Currently, various tubular retractors are widely used in the MISS of IDEM spinal tumors, primarily relying on microscopic visualization. To the best of the authors' knowledge, there is no report of pure endoscopic surgery with parallel non-expandable tubular retractors for IDEM spinal lesions. The present study reports a case series of IDEM spinal tumors that were treated via pure endoscopic MISS with a parallel non-expandable tubular retractor. The extent of tumor resection was evaluated by comparing preoperative and postoperative magnetic resonance imaging (MRI). The initial and follow-up clinical conditions were assessed according to the visual analog scale for pain and the modified McCormick scale for neurological status. Postoperative MRI demonstrated that all cases had achieved a gross total resection. After the operation, the clinical symptoms of all patients were significantly improved and there were no serious postoperative complications. At the initial follow-up, the pain experienced by the patients was significantly reduced or had even disappeared, and the neurological deficit was improved by at least one grade on the modified McCormick scale. The present report indicates that pure endoscopic MISS with a parallel non-expandable tubular retractor may be an effective and safe surgical strategy for IDEM spinal tumor resection.
Insights
Minimally invasive spinal surgery (MISS) using a pure endoscopic approach with parallel non-expandable tubular retractors offers a safe and effective strategy for intradural extramedullary (IDEM) spinal tumors. This technique achieved gross total resection and significant symptom improvement in patients.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Endoscopic Techniques
Background:
- Minimally invasive spinal surgery (MISS) is established for intradural extramedullary (IDEM) spinal tumors.
- Current MISS techniques primarily rely on microscopic visualization.
- Pure endoscopic approaches using parallel non-expandable tubular retractors for IDEM tumors have not been previously reported.
Purpose of the Study:
- To evaluate the safety and efficacy of pure endoscopic MISS with parallel non-expandable tubular retractors for IDEM spinal tumors.
- To assess the extent of tumor resection and clinical outcomes in a case series.
Main Methods:
- A case series of patients with IDEM spinal tumors treated with pure endoscopic MISS using parallel non-expandable tubular retractors.
- Tumor resection extent assessed by preoperative and postoperative MRI.
- Clinical outcomes evaluated using the visual analog scale for pain and the modified McCormick scale for neurological status.
Main Results:
- Postoperative MRI confirmed gross total resection in all cases.
- Patients experienced significant improvement in clinical symptoms, including reduced pain and improved neurological deficits.
- No serious postoperative complications were reported.
Conclusions:
- Pure endoscopic MISS with parallel non-expandable tubular retractors is a safe and effective surgical option for IDEM spinal tumors.
- This technique facilitates gross total resection and leads to significant clinical improvement.
- Further research may establish this as a standard approach for IDEM spinal tumor resection.