Laparoscopic assisted resection for retroperitoneal Dumbbell-shaped lumbar spinal schwannomas: operative technique and surgical results

Abstract Background Retroperitoneal Dumbbell lumbar spinal schwannomas (RDLSSs) classified as the Eden type 4 are composed of small intervertebral foramen components and large paravertebral components extending into the retroperitoneal cavity. The surgical management of RDLSSs s remains to be a grea...

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Bibliographic Details
Published in:World neurosurgery 2016-07, Vol.91, p.129-132
Main Authors: Shi, Wei, M.D, Su, Xing, M.D, Li, Wen-guang, M.D, Xu, Xi-de, M.D, Huang, Jian-fei, M.D, Chen, Jian, M.D
Format: Article
Language:English
Subjects:
Adult
Aftercare
Female
Humans
Laparoscopy
Laparoscopy - methods
Lumbar spinal tumor
Lumbar Vertebrae - surgery
Male
Middle Aged
Minimally invasive surgery
Neurilemmoma - surgery
Neurosurgery
Retroperitoneal Neoplasms - surgery
Retrospective Studies
Schwannoma
Spinal Neoplasms - surgery
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Summary:Abstract Background Retroperitoneal Dumbbell lumbar spinal schwannomas (RDLSSs) classified as the Eden type 4 are composed of small intervertebral foramen components and large paravertebral components extending into the retroperitoneal cavity. The surgical management of RDLSSs s remains to be a great challenge to all neurosurgeons due to the features of tumor. Objective To present our experience in the laparoscopic resection of RDLSSs, and to evaluate endoscopy surgery by an anterior approach for the treatment of RDLSSs. Methods We performed a retrospective review of 3 patients with RDLSSs undergoing laparoscopic surgery by an anterior approach were undertaken from June 2013 to July 2014. Patient demographics, operative reports, and pre- and postoperative images were reviewed. Result All tumors were completely removed with retroperitoneal laparoscopy by anterior approach. There were no major morbidities related to the surgical procedure in this series, and all patients recovered from surgery. The preoperative symptoms either improved or resolved in two patients while remained unchanged in one patient. Postoperative following up ranged from 12 to 24 months and none of the patients showed signs of tumor recurrence or spinal deformity. Conclusions The operative plan should tailor to the RDLSSs features. Retroperitoneal laparoscopy surgery by anterior approach can acquire safe and effective resection for RDLSSs with minimal postoperative complications. This procedure may be preferred for RDLSSs mainly located in the retroperitoneum without spinal canal extension.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2016.03.106