| Surgical Experiences of Dumbbell Tumors of the Cervical Spine Using a Modified Posterior Midline Exposure with Laminectomy and Complete Unilateral Facetectomy |
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Jong-Pil Eun, M.D. |
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Department of Neurosurgery, Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea |
| Surgical Experiences of Dumbbell Tumors of the Cervical Spine Using a Modified Posterior Midline Exposure with Laminectomy and Complete Unilateral Facetectomy |
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Jong-Pil Eun, M.D. |
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| Abstract |
Objective
This study is the experiences of the surgical managements of dumbbell tumors of the cervical spine, using a modified posterior midline exposure with laminectomy and complete unilateral facetectomy to consider the surgical technique, extent in resection of tumors, and potential spinal instability.
Methods
Ten patients with benign dumbbell tumors of the cervical spine were treated surgically from september 1998 to May 2004. The extents of tumors were measured anteromedially in C1-2 region and laterally from lateral dural margin on preoperative MRI films. Follow-up MRI with contrast enhancement were checked at 12 weeks postoperatively and plain films were obtained at 3 month interval during the 1st postoperative year and then annually.
Results
The author could achieve gross total resection of tumors extended laterally to 3cm from the lateral dural margin. One patient of neurofiroma extended 6cm from the lateral dural margin needed second operation by anterior approach. Eventhough tumors invaded anteromedially to the contralateral side of spinal cord(in C1-2 tumors), the author could achieve gross total resection of tumors. In an average of 48 months, ten patients showed no postoperative instabilities. In one patient of high cervical tumor(C1-2) developed hydrocephalus requiring shunt operation. There is no neurologic deficit due to the sacrifice of involved root.
Conclusion
In the present study, this exposure provides contiguous intraspinal, foraminal, and extraforaminal access that extends to 3cm from the lateral dural margin. A modified posterior midline exposure with laminectomy and complete unilateral facetectomy can be a useful method of surgery in dumbbell tumors of the cervical spine. |
| Keywords:
Dumbbell tumor.Cervical spine.Complete unilateral facetectomy |
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