New minimally invasive surgical removal of spine tumors extending into the neuroforamen from the spinal canal

Written by Banczerowski Péter, Misik Ferenc, Varga Ádám, Vajda János

In the previous decades spinal tumors located in the spinal canal were removed through posterior approach, which involved multilevel laminectomies and facetectomies. The common side-effects of this method are constant axial spinal-pain, the deformity and instability of the spinal column. The aim of this study was to develop a minimally invasive approach that can reduce the odds of the undesirable surgical consequences. Using hemi-semi laminectomy - through the interlaminar window-, we have enough place to remove the tumours located in the spinal canal. In case of tumors with intraforaminal component, hemi-semi laminectomy can be modified with a supraforaminal burr hole for the foramen exposure. The alternative type is the “open tunnel” technique, a hemi-semi laminectomy combined with lateral partial facetectomy. Both methods were suitable for the adequate tumor resection under the operating microscope according to the keyhole concept. The supraforaminal approach combined with hemi-semi-laminectomy was used in seven adult patients. The “open tunnel” method was used in nine cases. During the postoperative follow-up we haven’t found any new symptoms or complications. These modified surgical approaches fulfill the requirements of other minimally invasive techniques and help to prevent damage to the crucial posterior stabilizers of the spine, and disintegration of the vertebral arches and facet joints is reduced. The approach is suitable for exploring and removing neuromas located in the spinal canal and the neuroforamen.


Keywords: spine tumors, hemi-semi laminectomy, minimally invasive surgery

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