Microsurgical treatment for thoracic dumbbell shaped schwannoma under percutaneous tubular retractor system

doi:10.3877/cma.j.issn.2095-9141.2024.06.004

Abstract

Abstract:

Objective

To investigate the feasibility and safety of one-stage surgical resection of thoracic dumbbell shaped schwannoma under percutaneous tubular retractor system and microscopy.

Methods

A retrospective analysis was conducted on 43 cases of thoracic dumbbell shaped schwannoma treated by a combination of percutaneous tubular retractor system and microscopy in Neurosurgery Department of Fuzong Clinical Medical College of Fujian Medical University from June 2017 to December 2022. The patient's intraoperative bleeding volume， surgical time， hospital stay， and postoperative complications were recorded. The McCormick grading system was used to evaluate the improvement of spinal cord function in patients. The visual analog scale （VAS） was used to assess the level of pain in patients and the changes in scores before and after surgery were compared.

Results

All 43 cases of tumors were completely removed， and postoperative pathology confirmed that they were all schwannomas.Intraoperative bleeding was （85.2±16.7） mL， and the surgical time was 80.0 （68.0， 90.0） min. The length of hospital stay was 6.0 （5.0， 7.0） d. Two cases of pleural tear occurred during surgery and were immediately occluded，and no pneumothorax or pneumonia occurred after surgery.The last follow-up after surgery showed no thoracic vertebral deformities or tumor recurrence on CT and MRI. Forty-two cases（97.7%）showed improvement in spinal cord function，while 1 case （2.3%）showed no improvement.There was a statistically significant difference in the VAS scores of patients before surgery， at discharge， and at the last follow-up （P＜0.05）.

Conclusion

Combination of percutaneous tubular retractor system and microscope can safely remove thoracic dumbbell shaped schwannoma in one stage， reducing intraoperative bleeding and postoperative complications， shortening hospital stay， and reducing the incidence of spinal instability.

Key words: Dumbbell shaped tumor, Schwannomas, Thoracic vertebrae, Costal transverse joint, Percutaneous tubular retractor system, Microsurgery

Liang Xue, Yehuang Chen, Jianwu Wu, Zhaocong Zheng, Liangfeng Wei. Microsurgical treatment for thoracic dumbbell shaped schwannoma under percutaneous tubular retractor system[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(06): 340-344.

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References 21

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