World Neurosurg
-
Case Reports
Lamino-pedicular osteotomy for en-bloc resection of a posterolateral thoracic osteoblastoma: A technical note.
Osteoblastomas are a type of primary osseous neoplasm that exhibit a proclivity for the spine, primarily the posterior elements. While generally considered benign, some variants of osteoblastoma exhibit aggressive growth with lytic osseous destruction and soft tissue invasion, with some recurring after initial treatment. Given their proximity to vital structures and potential for rapid growth, these tumors are often managed with aggressive surgery, with en-bloc resection preferred. ⋯ This case bolsters the growing body of literature that favors the outcomes of a more conservative approach to en-bloc resection of spinal tumors.
-
Albeit rarely, different spinal pathologies may require surgical treatment during pregnancy. The management of such cases poses a series of challenges, starting with adequate body positioning. ⋯ Gestational age, surgical comfort and maternofetal safety should be balanced by a multidisciplinary team to tailor an adequate positioning plan for each individual case. The early third trimester is the more limiting period because of the womb hindrance favoring lateral or three-quarters positionings.
-
Resection of an anterolateral intramedullary lesion requires an approach that best provides a direct in-line access to the part of the lesion that presents at the pial surface, which enables total removal without injuring the spinal tracts. In Video 1, we show the technique of resection of an anterolateral intramedullary cavernoma. The vertebral level was identified before surgery, with coils placed percutaneously within the pedicle. ⋯ The dura was closed watertight. The wound was closed in layers. The posterolateral approach combined with rotation of the spinal cord by dentate ligament stitch allows direct visualization for lesions that present onto the anterolateral surface of the cord.
-
To evaluate the efficacy and safety of foraminoplasty using percutaneous transforaminal endoscopic discectomy (PTED) (performed with the aid of an endoscopic drill) to treat patients with axillary disc herniations. ⋯ Foraminoplasty featuring endoscopic drilling can be used to treat axillary-type lumbar disc herniations. The radiation exposure time is less than that of the trephine approach, but the drilling approach is less efficient. The short-term clinical outcomes afforded by the 2 methods do not differ.