Open Access

Novel combination of paraspinal keyhole surgery with a tubular retractor system leads to significant improvements in lumbar intraspinal extramedullary schwannomas

  • Authors:
    • Yuandong Zhuang
    • Gangfeng Cai
    • Chaofeng Fu
    • Weiqiang Zhang
    • Wei Zhao
    • Rui Wang
    • Chunhua Wang
    • Songsheng Shi
    • Chunmei Chen
  • View Affiliations

  • Published online on: October 18, 2017     https://doi.org/10.3892/ol.2017.7203
  • Pages:7873-7879
  • Copyright: © Zhuang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate the efficacy of combining paraspinal keyhole surgery with a tubular retractor system for the microsurgical removal of lumbar intraspinal extramedullary schwannomas. A retrospective analysis was conducted of 56 patients with lumbar intraspinal extramedullary schwannomas who were treated using the microsurgical paraspinal keyhole approach with a tubular retractor system. The mean ± standard deviation was calculated for the following parameters: Surgery time (96.21±14.64 min), hemorrhagic volume (28.54±9.72 ml), bed rest (2.55±0.5 days) and hospital stay (5.68±0.72 days). Two patients presented with cerebrospinal fluid leakage and one patient exhibited a nerve root injury. At a 6‑month follow‑up visit, postoperative Japanese Orthopedic Association (JOA) and visual analog scale (VAS) scores were evaluated. The mean ± standard deviation JOA scores were 12.00±2.07 for preoperative, 14.73±2.05 for 1 week postoperative, 20.07±2.32 for 3 months postoperative and 21.75±2.18 for 6 months postoperative. The improvement rate was 16.07, 47.48 and 59.77%, respectively. The mean ± standard deviation VAS scores were 6.64±1.31 for preoperative, 3.82±1.51 for 1 week postoperative, 2.11±1.17 for 3 months postoperative and 1.50±1.51 for 6 months postoperative. The JOA and VAS scores improved significantly (P<0.05). Magnetic resonance imaging and computed tomography were performed preoperatively, immediately following surgery and at the 6‑month postoperative visit to confirm the efficacy of the resections and evaluate spinal stability. No residual tumors were identified at follow‑up. No alterations in the stability of the spine were observed postoperatively. The combination of the microsurgical paraspinal keyhole approach with the tubular retractor system was successful in treating lumbar intraspinal extramedullary schwannomas. The surgical approach was associated with decreased hemorrhages, decreased duration of hospital stay, faster recovery and improved postoperative maintenance of spinal stability.

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December 2017
Volume 14 Issue 6

Print ISSN: 1792-1074
Online ISSN:1792-1082

2016 Impact Factor: 1.39
Ranked #68/217 Oncology
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APA
Zhuang, Y., Cai, G., Fu, C., Zhang, W., Zhao, W., Wang, R. ... Chen, C. (2017). Novel combination of paraspinal keyhole surgery with a tubular retractor system leads to significant improvements in lumbar intraspinal extramedullary schwannomas. Oncology Letters, 14, 7873-7879. https://doi.org/10.3892/ol.2017.7203
MLA
Zhuang, Y., Cai, G., Fu, C., Zhang, W., Zhao, W., Wang, R., Wang, C., Shi, S., Chen, C."Novel combination of paraspinal keyhole surgery with a tubular retractor system leads to significant improvements in lumbar intraspinal extramedullary schwannomas". Oncology Letters 14.6 (2017): 7873-7879.
Chicago
Zhuang, Y., Cai, G., Fu, C., Zhang, W., Zhao, W., Wang, R., Wang, C., Shi, S., Chen, C."Novel combination of paraspinal keyhole surgery with a tubular retractor system leads to significant improvements in lumbar intraspinal extramedullary schwannomas". Oncology Letters 14, no. 6 (2017): 7873-7879. https://doi.org/10.3892/ol.2017.7203