Modified Unilateral Approach for Ventrally Located Spinal Tumors.

Area of Science:

• Neurosurgery
• Spinal Surgery
• Surgical Oncology

Background:

• Ventral spinal tumors pose significant surgical challenges due to the need for posterior approaches, cord manipulation, and extensive laminectomy.
• Conventional posterior approaches can be invasive and carry risks associated with spinal cord manipulation.
• Existing unilateral approaches often provide limited surgical fields and viewing angles.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified unilateral surgical approach for ventrally located spinal tumors.
• To assess the surgical outcomes, including tumor removal extent and neurological complications.
• To investigate the degree of paraspinal muscle atrophy following the modified unilateral approach.

Main Methods:

• A modified unilateral surgical technique involving horizontal skin/fascia incision and longitudinal retractors was applied to 15 patients with ventral spinal tumors.
• Tumor types included schwannomas, meningiomas, and others.
• Postoperative magnetic resonance imaging was used to evaluate paraspinal muscle atrophy.

Main Results:

• The modified unilateral approach yielded an excellent surgical field for tumor removal.
• Gross total tumor removal was achieved in 11 patients (92% of benign tumors).
• No major neurological complications were observed, with only one case of transient weakness; no late wound complications occurred.
• A statistically nonsignificant 7% reduction in paraspinal muscle cross-sectional area was noted on the approach side.

Conclusions:

• The modified unilateral approach is a simple and effective technique for resecting ventrally located spinal tumors.
• This method provides adequate surgical exposure while minimizing invasiveness and complications.
• The approach demonstrates potential for safe and successful management of ventral spinal pathologies.