Title :

Minimally invasive resection of large dumbbell tumors of the lumbar spine: advantages and pitfalls

Author(s) :

Zairi, Fahed [Auteur]
Troux, Camille [Auteur]
Sunna, Tarek [Auteur]
Karnoub, Melodie-Anne [Auteur]
Boubez, Ghassan [Auteur]
Shedid, Daniel [Auteur]

Journal title :

Clinical Neurology and Neurosurgery

Abbreviated title :

Clin. Neurol. Neurosurg.

Volume number :

168

Pages :

91-96

Publication date :

2018-05-01

ISSN :

0303-8467

Keyword(s) :

Minimally invasive
Dumbbell tumor
Biopsy
Schwannoma

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVES: The surgical management of dumbbell tumors of the lumbar spine remains controversial, because of their large volume and complex location, involving both the spinal canal and the retro peritoneum. While sporadically ...
Show more >OBJECTIVES: The surgical management of dumbbell tumors of the lumbar spine remains controversial, because of their large volume and complex location, involving both the spinal canal and the retro peritoneum. While sporadically reported, our study aims to confirm the value of minimally invasive posterior access for the complete resection of large lumbar dumbbell tumors. PATIENTS AND METHODS: In this prospective study, we included all consecutive patients who underwent the resection of a voluminous dumbbell tumor at the lumbar spine through a minimally invasive approach, between March 2015 and August 2017. There were 4 men and 4 women, with a mean age at diagnosis of 40.6 years (range 29-58 years). The resection was performed through a trans muscular tubular retractor by the same surgical team. Operative parameters and initial postoperative course were systematically reported. Clinical and radiological monitoring was scheduled at 3 months, 1year and 2years. RESULTS: The mean operative time was 144min (range 58-300 minutes) and the mean estimated blood loss was 250ml (range 100-500ml). Gross total resection was achieved in all patients. No major complication was reported. The mean length of hospital stay was 3.1 days (range 2 to 6 days). Histological analysis confirmed the diagnosis of grade 1 schwannoma in all patients. The mean follow up period was 14.9 months (range 6 to 26 months), and 5 patients completed at least 1-year follow-up. At 6 months the Macnab was excellent in 6 patients, good in one patient and fair in one patient because of residual neuropathic pain requiring the maintenance of a long-term treatment. No tumor recurrence was noted to date. CONCLUSION: Lumbar dumbbell tumors can be safely and completely resected using a single-stage minimally invasive procedure, in a trained team.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

INSERM
Université de Lille

Collections :

• Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192

Submission date :

2022-06-15T13:58:30Z