Minimally invasive tubular removal of spinal schwannoma and neurofibroma - a case series of 49 patients and review of the literature.


Journal

Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181

Informations de publication

Date de publication:
10 Aug 2024
Historique:
received: 13 05 2024
accepted: 01 08 2024
revised: 22 07 2024
medline: 10 8 2024
pubmed: 10 8 2024
entrez: 9 8 2024
Statut: epublish

Résumé

To evaluate the efficacy and safety of minimally invasive tubular removal of spinal schwannoma and neurofibroma. In this single-centre study, we retrospectively analysed 49 consecutive patients who underwent minimally invasive removal of a total of 51 benign spinal nerve sheath tumors using a non-expandable (n = 18) or expandable tubular retractor (n = 33) retractor system between June 2007 and December 2019. The extent of resection, surgical complications, neurological outcome, operative time, and estimated blood loss were recorded. Histopathology revealed 41 schwannomas and 10 neurofibromas. After a mean follow-up of 30.8 months, postoperative MRI showed gross total resection in 93.7%, and subtotal resection in 6.3% of the tumors. Three patients were lost to follow up. Of the subtotal resections, one was a schwannoma (2.4% subtotal resections in schwannomas) and two were neurofibromas (20.0% subtotal resections in neurofibromas). Intraspinal and paraspinal tumor localizations were equally accessible by minimally invasive tubular surgery. Conversion to open surgery was not required in any case. The mean operative time was 167 ± 68 min, and estimated blood loss was 138 ± 145 ml. We observed no major surgical complications. Spinal schwannoma and neurofibroma can be removed effectively and safely using a minimally invasive tubular approach, with satisfying extent of tumor resection comparable to the conventional open surgical technique and no increased risk for neurological deterioration.

Identifiants

pubmed: 39123090
doi: 10.1007/s10143-024-02656-x
pii: 10.1007/s10143-024-02656-x
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

418

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Katerina Argiti (K)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany. katerina.argiti@uniklinik-freiburg.de.

Ralf Watzlawick (R)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Marc Hohenhaus (M)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Ioannis Vasilikos (I)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Florian Volz (F)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Roland Roelz (R)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Christoph Scholz (C)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Ulrich Hubbe (U)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Jürgen Beck (J)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

Matthias Neef (M)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.
Department of Neurosurgery, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.

Jan-Helge Klingler (JH)

Department of Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, D-79106, Freiburg, Germany.

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