Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Mini Review Volume 4 Issue 1

Surgical Resection of Spinal Intradural Extramedullary Neoplasms: Policy According to the Lesion Location

Derya Burcu Hazer Rosberg1*, Selim Ayhan2 and Selçuk Palaoğlu3

1Department of Neurosurgery, Muğla Sıtkı Koçman University, Muğla, Turkey
2Department of Neurosurgery, Baskent University Hospital, Ankara, Turkey
3Department of Neurosugery, Acibadem Ankara Hospital, Ankara, Turkey and Emeritus Professor of Hacettepe University School of Medicine, Ankara, Turkey

*Corresponding Author: Derya Burcu Hazer Rosberg, Department of Neurosurgery, Muğla Sıtkı Koçman University, Muğla, Turkey.

Received: November 18, 2020; Published: December 14, 2020

×

Abstract

Background: Intradural extramedullary (IDEM) tumors account for two thirds of all primary intraspinal neoplasms. They mostly include schwannomas, meningiomas and ependymomas which are located circumferentially anywhere by the spinal cord. Since the clinical symptoms and histology of these tumors are mostly benign in nature, the primary goal of the treatment should be gross total resection without any functional deterioration.

Objective: In cases of intradural extramedullary tumors, surgery should be planned with respect to preservation of the stability and the anatomy of the spine without giving any harm to surrounding vital structures. Therefore, surgical policy should be planned thoroughly for the best outcome.

Methods: The authors shall discuss the surgical policy according to the localization of these neoplasms, especially the minimally invasive attempts in accordance with the most recent literature.

Results: IDEM spinal tumors is classified according to their relation with spinal cord and the denticulate ligament; posterior, posterolateral, lateral, anterolateral, and anterior. The trajectory and surgical techniques are discussed in detail in each group with cases of our own experience.

Conclusion: Surgical excision of these benign lesions should be planned according to the localization of the tumor in order to achieve gross total resection with minimal harm to vital structures.

Keywords: Approach; Intradural Extramedullary; Tumor; Laminectomy; Minimally Invasive

×

References

  1. Ahn D K., et al. "The Surgical Treatment for Spinal Intradural Extramedullary Tumors”. Clinics in Orthopedic Surgery 3 (2009): 165-172.
  2. Sim J E., et al. "Removal of Intradural-Extramedullary Spinal Cord Tumors with Unilateral Limited Laminectomy”. Journal of Korean Neurosurgery Society 5 (2008): 232-236.
  3. Gowers W R and V. Horsley. "A Case of Tumour of the Spinal Cord. Removal; Recovery”. Medico-Chirurgical Transactions 71 (1888): 377-430.
  4. Tredway T L., et al. "Minimally Invasive Resection of Intradural-Extramedullary Spinal Neoplasms”. Neurosurgery 1 (2006): ONS52-8; discussion ONS52-8.
  5. Levy W J., et al. "Spinal Neurofibromas: A Report of 66 Cases and a Comparison with Meningiomas”. Neurosurgery 3 (1986): 331-334.
  6. Lu D C., et al. "A Comparison of Mini-Open and Open Approaches for Resection of Thoracolumbar Intradural Spinal Tumors”. Journal of Neurosurgery Spine 6 (2011): 758-764.
  7. Seppala M T., et al. "Long-Term Outcome after Removal of Spinal Schwannoma: A Clinicopathological Study of 187 Cases”. Journal of Neurosurgery 4 (1995): 621-626.
  8. Cristante L and H. D. Herrmann. "Surgical Management of Intramedullary Spinal Cord Tumors: Functional Outcome and Sources of Morbidity”. Neurosurgery 1 (1994): 69-74; discussion 74-76.
  9. Iguchi T., et al. "Minimum 10-Year Outcome of Decompressive Laminectomy for Degenerative Lumbar Spinal Stenosis”. Spine (Phila Pa 1976) 14 (2000): 1754-1759.
  10. Papagelopoulos P J., et al. "Spinal Column Deformity and Instability after Lumbar or Thoracolumbar Laminectomy for Intraspinal Tumors in Children and Young Adults”. Spine (Phila Pa 1976) 4 (1997): 442-451.
  11. Dangelmajer S., et al. "Minimally Invasive Spine Surgery for Adult Degenerative Lumbar Scoliosis”. Neurosurgery Focus 5 (2014): E7.
  12. Deutsch H. "Minimally Invasive Lumbar Foraminotomy”. Neurosurgery Focus 2 (2013): Video 7.
  13. Haji F A., et al. "Minimally Invasive Approach for the Resection of Spinal Neoplasm”. Spine (Phila Pa 1976) 15 (2011): E1018-1026.
  14. Mannion R J., et al. "Safety and Efficacy of Intradural Extramedullary Spinal Tumor Removal Using a Minimally Invasive Approach”. Neurosurgery 1 (2011): 208-216; discussion 16.
  15. Gebauer G P., et al. "Magnetic Resonance Imaging of Spine Tumors: Classification, Differential Diagnosis, and Spectrum of Disease”. Journal of Bone and Joint Surgery 90 (2008): 146-162.
  16. Sun C X., et al. "Unilateral Hemilaminectomy for Patients with Intradural Extramedullary Tumors”. Journal of Zhejiang University Science B 7 (2011): 575-581.
  17. Turel M K and V Rajshekhar. "Magnetic Resonance Imaging Localization with Cod Liver Oil Capsules for the Minimally Invasive Approach to Small Intradural Extramedullary Tumors of the Thoracolumbar Spine”. Journal of Neurosurgery Spine 6 (2014): 882-885.
  18. Hoover J M., et al. "Intradural Spinal Metastases: A Surgical Series of 15 Patients”. Acta Neurochire (Wien) 5 (2012): 871-877; discussion 77.
  19. Panjabi M M and A A White, 3rd. "Basic Biomechanics of the Spine”. Neurosurgery 1 (1980): 76-93.
  20. Oktem I S., et al. "Hemilaminectomy for the Removal of the Spinal Lesions”. Spinal Cord 2 (2000): 92-96.
  21. Yasuoka S., et al. "Pathogenesis and Prophylaxis of Postlaminectomy Deformity of the Spine after Multiple Level Laminectomy: Difference between Children and Adults”. Neurosurgery 2 (1981): 145-152.
  22. Abbott R., et al. "Osteoplastic Laminotomy in Children”. Pediatric Neurosurgery 3 (1992): 153-156.
  23. Gandhi R H and J W German. "Minimally Invasive Approach for the Treatment of Intradural Spinal Pathology”. Neurosurgery Focus 2 (2013): E5.
  24. Nzokou A., et al. "Minimally Invasive Removal of Thoracic and Lumbar Spinal Tumors Using a Nonexpandable Tubular Retractor”. Journal of Neurosurgery Spine 6 (2013): 708-715.
  25. Tan LA., et al. "Management of Intended Durotomy in Minimally Invasive Intradural Spine Surgery: Clinical Article”. Journal of Neurosurgery Spine 2 (2014): 279-285.
  26. Canbay S., et al. "Management of Thoracal and Lumbar Schwannomas Using a Unilateral Approach without Instability: An Analysis of 15 Cases”. Asian Spine Journal 1 (2012): 43-49.
  27. Koch-Wiewrodt D., et al. "Unilateral Multilevel Interlaminar Fenestration Instead of Laminectomy or Hemilaminectomy: An Alternative Surgical Approach to Intraspinal Space-Occupying Lesions. Technical Note”. Journal of Neurosurgery Spine 5 (2007): 485-492.
  28. Park M S., et al. "Minimally Invasive Anterolateral Corpectomy for Spinal Tumors”. Neurosurgery Clinics of North America 2 (2014): 317-325.
  29. Banczerowski P., et al. "Modified Minimally Invasive Surgical Approach to Cervical Neuromas with Intraforaminal Components: Hemi-Semi-Laminectomy and Supraforaminal Burr Hole (Modified Foraminotomy) Technique”. Minimally Invasive Neurosurgery 1 (2009): 56-58.
  30. Arima H., et al. "Surgical Management of Spinal Meningiomas: A Retrospective Case Analysis Based on Preoperative Surgical Grade”. Surgical Neurology International 5 (2014): S333-338.
  31. Nanda A., et al. "Surgical Strategies in the Management of Spinal Nerve Sheath Tumors”. World Neurosurgery (2015).
  32. Taylor A S. "X. Unilateral Laminectomy”. Annuals of Surgery 4 (1910): 529-533.
  33. Joaquim A F., et al. "Surgical Management of Intradural Extramedullary Tumors Located Anteriorly to the Spinal Cord”. Journal of Clinical Neuroscience 8 (2012): 1150-1153.
  34. Acosta F L Jr., et al. "Modified Paramedian Transpedicular Approach and Spinal Reconstruction for Intradural Tumors of the Cervical and Cervicothoracic Spine: Clinical Experience”. Spine (Phila Pa 1976) 6 (2007): E203-210.
  35. Voulgaris S., et al. "Posterior Approach to Ventrally Located Spinal Meningiomas”. European Spine Journal 7 (2010): 1195-1199.
  36. Yu Y., et al. "Minimally Invasive Microsurgical Treatment of Cervical Intraspinal Extramedullary Tumors”. Journal of Clinical Neuroscience 9 (2011): 1168-1173.
  37. Angevine P D., et al. "Surgical Management of Ventral Intradural Spinal Lesions”. Journal of Neurosurgery Spine 1 (2011): 28-37.
  38. Caputy A. J., et al. "The Role of Spinal Fusion in Surgery for Lumbar Spinal Stenosis: A Review”. Neurosurgery Focus 2 (1997): e3; discussion 1 p following e4.
  39. McGirt M J., et al. "Short-Term Progressive Spinal Deformity Following Laminoplasty Versus Laminectomy for Resection of Intradural Spinal Tumors: Analysis of 238 Patients”. Neurosurgery 5 (2010): 1005-1012.
  40. Sciubba DM., et al. "Factors Associated with Cervical Instability Requiring Fusion after Cervical Laminectomy for Intradural Tumor Resection”. Journal of Neurosurgery Spine 8 (2008): 413-419.
  41. Bresnahan L., et al. "A Biomechanical Evaluation of Graded Posterior Element Removal for Treatment of Lumbar Stenosis: Comparison of a Minimally Invasive Approach with Two Standard Laminectomy Techniques”. Spine (Phila Pa 1976) 1 (2009): 17-23.
  42. Ogden AT., et al. "Biomechanical Comparison of Traditional and Minimally Invasive Intradural Tumor Exposures Using Finite Element Analysis”. Clinical Biomechanics (Bristol, Avon) 2 (2009): 143-147.
  43. Gu R., et al. "Evaluation of Hemilaminectomy Use in Microsurgical Resection of Intradural Extramedullary Tumors”. Oncology Letter 5 (2014): 1669-1672.
  44. Tarantino R., et al. "Surgery of Intradural Extramedullary Tumors: Retrospective Analysis of 107 Cases”. Neurosurgery 75 ( 2014): 509-514; discussion 14.
  45. Wong A P., et al. "Comparison of Open and Minimally Invasive Surgery for Intradural-Extramedullary Spine Tumors”. Neurosurgical focus 2 (2015): E11.
  46. Dickman C A and R I Apfelbaum. "Thoracoscopic Microsurgical Excision of a Thoracic Schwannoma. Case Report”. Journal of Neurosurgery 5 (1998): 898-902.
  47. Jenny B., et al. "[Transthoracic Transvertebral Approach for Resection of an Anteriorly Located, Calcified Meningioma. Case Report]”. Neurochirurgie 1 (2002): 49-52.
  48. O'Toole J E and P C McCormick. "Midline Ventral Intradural Schwannoma of the Cervical Spinal Cord Resected Via Anterior Corpectomy with Reconstruction: Technical Case Report and Review of the Literature”. Neurosurgery 6 (2003): 1482-1485; discussion 85-86.
×

Citation

Citation: Derya Burcu Hazer Rosberg., et al. “Surgical Resection of Spinal Intradural Extramedullary Neoplasms: Policy According to the Lesion Location". Acta Scientific Neurology 4.1 (2021): 07-14.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days
Impact Factor0.844

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is March 20, 2021.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US