Surgical resection of intradural extramedullary tumors in the atlantoaxial spine via a posterior approach  

作　　者：Di-Hua Meng Jia-Qi Wang Kun-Xue Yang Wei-You Chen Cheng Pan Hua Jiang 

机构地区：[1]Department of Spine Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Province,China

出　　处：《World Journal of Clinical Cases》2022年第1期62-70,共9页世界临床病例杂志

基　　金：the National Natural Science Foundation of China,No.81860406;Guangxi Natural Science Foundation,No.2018GXNSFAA281127;Medical Excellence Award Funded by the Creative Research Development Grant from The First Affiliated Hospital of Guangxi Medical University.

摘　　要：BACKGROUND The anatomical features of the atlantoaxial spine increase the difficulty of complete and safe removal of atlantoaxial intradural extramedullary(IDEM)tumors.Studies concerning surgical interventions via a posterior approach are limited.AIM To investigate the safety and efficacy of atlantoaxial IDEM tumor resection using a one-stage posterior approach.METHODS We retrospectively analyzed clinical databases for one-stage atlantoaxial IDEM tumor resection via a posterior approach between January 2008 and January 2018.The analyzed data included tumor position,histopathological type,pre-and postoperative Japanese Orthopedic Association(JOA)scores and Nurick grades,postoperative complication and recurrence status.RESULTS A total of 13 patients who underwent C1-C2 Laminectomy and/or unilateral facetectomy via the posterior approach were enrolled in the study.In all cases reviewed,total tumor resection and concomitant C1-C2 fusion were achieved.The average follow-up was 35.3±6.9 mo(range,26-49 mo).A statistically significant difference was noted between the preoperative JOA score(11.2±1.1)and the score at the last final follow-up(15.6±1.0)(P<0.05).A statistically significant difference was noted between the preoperative Nurick grade(2.3±0.9)and that at the last follow-up(1.2±0.4)(P<0.05).However,no statistically significant difference was noted between the preoperative and last follow-up C1-2 Cobb angle and C2-7 Cobb angle(P>0.05).No mortalities,severe complications or tumor recurrence were observed during the follow-up period.CONCLUSION Total resection of atlantoaxial IDEM tumors is feasible and effective via a posterior approach.Surgical reconstruction should be considered to avoid iatrogenic kyphosis and improve spinal stability and overall clinical outcomes.

关 键 词：Atlantoaxial spine Cervical spine Extramedullary tumors Intardural tumer Posterior approach Surgical resection 

分 类 号：R739.42[医药卫生—肿瘤]