Refining the far-lateral pathway: ten-year outcomes of posterolateral transforaminal resection of spinal tumors.

Abstract

Objective: The posterolateral transforaminal approach, which has been used to treat foraminal and far-lateral disc herniations for a long time, has also become a reliable method for accessing spinal tumours. This method takes advantage of the neural foramen's natural anatomical pathway, which allows for the removal of the tumour with minimal damage to the surrounding osseoligamentous structures. This study examines 10 years of spinal tumours treated with this method by a single experienced neurosurgeon.

Methods: A total of 40 patients who underwent 40 surgeries between 2008 and 2018 were reviewed. We examined the patients' demographics, the location of the tumour, the histopathological diagnosis, the extent of the resection, and the surgical outcomes. The lesions were located in the lumbar region, and the same posterolateral transforaminal technique was employed for all surgeries.

Results: The cohort included 21 men and 19 women in the group, and the average age was 49.2 years (range: 14-75). Schwannomas (n = 27) and metastatic tumors (n = 9) were the most common histopathologies. In 38 cases, the whole tumor was removed, and in 2 cases, only part of it was removed. The method made it possible to safely and effectively reach the lateral and anterior spinal canal compartments, with few complications and good results after surgery.

Conclusion: The posterolateral transforaminal approach represents a reliable, minimally invasive corridor for the surgical management of selected spinal tumours. Our decade-long, single-surgeon experience supports its utility in achieving adequate resection with minimal morbidity, especially in tumours localised to the far lateral and foraminal zones of the spine.