The Treatment Of Intra- And Extra-spinal Dumbbell-shaped Tumor By Keyhole Technique Of Microsurgery

Objective:To investigate the clinical effects of intra-and extra-spinal dumbbell-shaped tumor by keyhole technique of microsurgery.Methods:Clinical data from January 2013 to June 2018 of 15 patients with intra-and extra-spinal dumbbell-shaped tumor were retrospectively studied.The tumor was located in the cervical spine in 4 cases,cervicothoracic junction in 3 cases,thoracic spine in 6 cases,thoracolumbar in 1 case and lumber spine in 1 case.The intra-and extra-spinal dumbbell-shaped tumor of above 15 cases were resected with keyhole microsurgery under neurophysiological monitoring.The operative time,blood loss,tumor size,hospitalization time and related complications of 15 patients were recorded and analyzed.Visual analogue scale(VAS)and American Spinal Injury Association(ASIA)score were employed to evaluate clinical efficacy.Result:All operations were completed successfully.The operation time was 100-290 minutes with an average of 185.33±47.59 minutes.The blood loss was 50-300 ml with an average of 161.11±69.92 ml.The hospital stay was 5-18 days,with an average of 9.00±3.16 days.Intraoperative neurophysiological monitoring: SEP amplitude did not decrease significantly,MEP amplitude did not disappear,and EMG did not show continuous explosive muscle contraction.The patients were followed up for 6-52 months,with an average of 31.00±15.50 months.The VAS score of 14 patients(93.33%)was significantly lower than that before surgery,and the pain was significantly relieved.The ASIA score was improved after surgery.The ASIA classification of All patients demonstrated neurologic stability or improvement by 1-2 grades: 13.33% remained stable,33.33% increased by 1 grade and 53.33% increased by 2 grade?Conclusion:Keyhole technique microsurgery can be successfully used for intra-and extra-spinal dumbbell-shaped tumor resection.It can not only achieve the goal of fully exposed and removal of the tumor,but also reduce the injury of vertebral muscles,joints,ligament.It has the merits of less trauma,less bleeding and ripid rehabilitation.