Posterior Laminoplastic Laminotomy Combined with a Paraspinal Transmuscular Approach for Removing a Lumbar Dumbbell-shaped Schwannoma: A Technical Note

Neurologia Medico-chirurgica
Japhet Gideon NgeragezaKazuhiro Hongo

Abstract

The surgical strategies and methods used to treat dumbbell-shaped tumors located in the lumbar-foraminal region are controversial. Although a total facetectomy and combined intra- and extraspinal canal approach provide a wide operative field, facet fusion is required, which can be rather invasive. Here, we report a successful removal of a lumbar dumbbell-shaped schwannoma using a combined laminoplastic laminotomy with Wiltse's paraspinal surgical approach. This was performed under an operating microscope without a complete facetectomy, fusion, and posterior fixation. Briefly, we treated two patients with lumbar foraminal tumors, both dumbbell-shaped schwannomas located in the intra- and extradural portion. After a laminoplastic laminotomy, the intradural tumor was removed. The tumor located at the extracanalicular site was removed after drilling the pars interarticularis of the lamina, which was performed to enlarge the intervertebral foramen via Wiltse's paraspinal surgical approach. During surgery, facetectomy with posterior fixation was not needed to remove the intraforaminal component. There was no lumbar instability or complication after surgery. Our results suggest that a combined posterior laminoplastic laminotomy and Wi...Continue Reading

References

Nov 27, 2002·Journal of Neurosurgery·Rajaraman ViswanathanStewart B Dunsker
Mar 1, 1948·Annals of Surgery·J D Lane, E S Moore
Dec 14, 2007·Journal of Neurosurgery. Spine·Hiroshi OzawaChikashi Kawahara
Sep 13, 2013·British Journal of Neurosurgery·Kiyoshi ItoKazuhiro Hongo

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