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Surgery for ventral intradural thoracic spinal tumors with a posterolateral transpedicular approach

  • Clinical Article - Spine
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Abstract

Background

Surgery for ventrally seated thoracic tumors requires an anatomically specific approach that is distinct from cervical or lumbar spinal cord surgery as the narrower spinal canal of the thoracic spinal cord makes it sensitive to surgical procedures. However, reports describing this operative technique are few. To obtain a wide operative field and minimize thoracic spinal cord retraction, we employed a posterolateral transpedicular approach in ventral-located tumors and investigated the efficacy and limitations of this technique.

Method

Eighteen patients with lesions (meningioma or neurinoma) located in the ventral intradural thoracic region were surgically treated between 2009 and 2014. The relationship among the clinical outcome, tumor location, and postoperative spinal alignment was analyzed.

Results

Postoperative neurological function improved in all patients, namely those with meningioma (p = 0.012) and schwannoma (p = 0.018). One patient who underwent removal of two facet joints suffered a postoperative compression fracture. Removal of two facet joints and pedicles resulted in a worsening of spinal alignment (p = 0.03), while this was not the case for the removal of one facet joint and pedicle (p = 0.72).

Conclusions

This case series clarified the benefits of the posterolateral transpedicular approach for resection of ventral intradural extramedullary tumors. Removal of one pedicle and facet joint seems to be more beneficial.

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Acknowledgments

We thank Mr. S. Ono, Mr. M. Koinuma, Mr. T. Mimura, and Ms. E. Ayaka for their technical support during this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Kiyoshi Ito, Tatsuro Aoyama, Yoshinari Miyaoka, Tatsuya Seguchi, Tetsuyoshi Horiuchi & Kazuhiro Hongo

Authors
  1. Kiyoshi Ito
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  2. Tatsuro Aoyama
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  3. Yoshinari Miyaoka
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  4. Tatsuya Seguchi
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  5. Tetsuyoshi Horiuchi
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  6. Kazuhiro Hongo
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Corresponding author

Correspondence to Kiyoshi Ito.

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Funding

Japan Society for the Promotion of Science (JSPS) provided financial support in the form of Grants-in Aid for Scientific Research: KAKENHI.

This work was supported by JSPS KAKENHI grant no. 15 K10356.

The sponsor had no role in the design or conduct of this research.

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ito, K., Aoyama, T., Miyaoka, Y. et al. Surgery for ventral intradural thoracic spinal tumors with a posterolateral transpedicular approach. Acta Neurochir 158, 1563–1569 (2016). https://doi.org/10.1007/s00701-016-2864-7

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  • DOI: https://doi.org/10.1007/s00701-016-2864-7

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