Extensive Posterolateral Approach for Giant Spinal Epidural Tumors

Janez Ravnik, Jan Štangelj, Jaka Košar

Abstract


Objective. Our objective was to determine the safety, efficacy, and surgical outcome of an extensive posterolateral approach for giant spinal epidural tumors.

Materials and Methods. Our clinical study included 12 patients with various giant primary tumors and metastases of the spine, who underwent surgery between 2008 and 2019. The surgical procedure consisted of costotransversectomy, laminectomy, corpectomy, tumor resection, spinal column stabilization, and reconstruction. Neurological status examination and pain assessment were recorded at the time of admission, upon discharge and at outpatient check-up.

Results. In our clinical sample, there were no major perioperative complications. All patients were discharged from the intensive care unit back to the hospital department within a week after the surgery. Postoperative follow-up showed no deterioration of neurological status. Furthermore, there was a moderate to significant improvement of paraparesis in all patients for weeks after surgery. The most notable improvement was significant pain relief in all the patients. None of the patients had issues with failure of the implanted hardware. Two patients died less than six months after the surgery due to the progression of the primary malignant process.

Conclusion. An extensive posterolateral approach to giant spinal epidural tumors is an effective one-step approach. It presents a good compromise between invasiveness and sufficient exposure for both tumor resection and spinal column reconstruction. Good short-term clinical improvement can be achieved, but the long term results depend on the advancement of the initial disease. Careful evaluation and selection of patients are necessary to achieve clinical improvement and prolonged life expectancy, and the best results are achieved with a multidisciplinary approach.


Keywords


Spinal Epidural Tumor; Neurosurgical Procedure; Posterolateral Approach; Complete Tumor Resection; Stabilization

Full Text:

PDF


DOI: http://dx.doi.org/10.5644/ama2006-124.304

Refbacks

  • There are currently no refbacks.


2019 Department of Medical Sciences, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina. All rights reserved.
 
The full text of articles published in this journal can be used free of charge for personal and educational purposes while respecting authors and publishers’ copyrights. For commercial purposes no part of this journal may be reproduced without the written permission of the publisher.