Minimally invasive tubular approach to intramedullary cavernous malformations.

Surgical neurology international Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI:10.25259/SNI_375_2024
Maia Sophia Kantorowski, James Benning Walker
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Abstract

Background: Advancements in minimally invasive spinal surgery have led to an expansion of targeted pathologies as well as improvements in surgical outcomes compared to their conventional counterparts through open laminectomy; however, this technique is rarely mentioned in the literature for intrinsic cord lesions. The authors present a novel minimally invasive, dorsolateral, and expandable tubular approach for the resection of an intradural, intramedullary thoracic cavernous malformation (CM).

Case descriptions: A 52-year-old male patient presented with rapidly progressive myelopathy and loss of ambulatory capabilities, with which magnetic resonance imaging revealed a hemorrhagic CM within the thoracic spinal cord. The CM was successfully resected through a minimally invasive tubular approach utilizing a dorsal root entry zone myelotomy. Postoperative imaging confirmed gross resection. His motor examination rapidly recovered, and he remains ambulatory with the use of a cane at a 2-year follow-up.

Conclusion: This novel minimally invasive approach is a promising technique for well-selected cases of symptomatic spinal CMs. Further exploration and potentially randomized studies are necessary to fully affirm the tubular approach's suitability for the treatment of intradural intramedullary CMs compared to conventional techniques.

微创管状法治疗髓内海绵畸形。
背景:脊柱微创手术的进步扩大了目标病变的范围,与传统的开放性椎板切除术相比,手术效果也有所改善;然而,文献中很少提到这种技术用于脊髓内病变的治疗。作者介绍了一种新颖的微创、背外侧和可扩张管状方法,用于切除硬膜内、髓内胸腔空洞畸形(CM):一名 52 岁的男性患者出现了快速进展性脊髓病,丧失了行动能力,磁共振成像显示胸椎脊髓内有一个出血性海绵状畸形。通过微创管状入路,利用背根入口区脊髓切开术成功切除了肿瘤。术后造影证实肿瘤已被完全切除。他的运动检查迅速恢复,随访两年后仍可使用拐杖行走:结论:这种新型微创方法是一种很有前途的技术,适用于经过严格筛选的症状性脊髓脊膜瘤病例。与传统技术相比,有必要进行进一步的探索和可能的随机研究,以充分肯定管状方法在治疗髓内脊髓肿瘤方面的适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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