Feasibility of the Posterior Approach for Removal of Ventrolateral Extended Intradural Tumors
Journal Title: PARIPEX-Indian Journal of Research - Year 2016, Vol 5, Issue 3
Abstract
Management of ventral intradural spinal tumors is usually achieved through a posterior approach. However, a posterolateral approach may be required for some ventral lesions contralateral from the approach side. The authors describe the feasibility of these approaches of ventral intradural lesions and present the surgical outcomes in these cases. There were 19 cases of ventral intradural lesions: 9 meningiomas, 9 schwannomas, and 1 neurenteric cyst. Seven of these were cervical and 12 were thoracic lesions. Tumors were removed through a space between the dura and spinal cord without retraction and rotation of the spinal cord. Fourteen and five cases required posterior and posterolateral approaches, respectively. Two lesions in the thoracic spine required laminectomy with partial facetectomy, and 3 in the thoracic spine required facetectomy and transversectomy. To evaluate the extent of tumor localization, the tumor localized angles were measured on axial crosssections. Larger tumor localized angles indicated larger ventrolateral extension of tumors. The posterior approach could not be employed for five tumors in the thoracic spine that showed tumor localized angle over 215. Tumors were completely removed in 18 patients, whereas 1 patient underwent a subtotal resection. All patients had improved neurological status. Although posterior approaches provide adequate exposure to safely remove the majority of these lesions, the posterolateral approach was needed to expose tumors with ventrolateral extension. However, future studies with more ventral intradural spine tumor cases are required to fully elucidate these findings.
Authors and Affiliations
Koichi Iwatsuki, Yu-ichiro Ohnishi, Koshi Ninomiya, Toshika Ohkawa, Toshiki Yoshimine
Keywords
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