title: Single-stage removal of thoracic dumbbell tumors from a posterior approach only with costotransversectomy.
abstract: OBJECTIVE
  Thoracic dumbbell tumors are relatively rare, usually arising from neurogenic elements. Methods for surgical removal thereof remain controversial. The purpose of this study was to evaluate the surgical results of a single-stage posterior approach with laminectomy and costotransversectomy only for the management of thoracic dumbbell tumors.
  
  
  METHODS
  Eight cases of thoracic large dumbbell tumor were analyzed retrospectively: seven men and one woman (mean age, 49 years). Pathologic findings included schwannoma in five patients, neurofibroma in two patients (Recklinghausen in one patient), and ganglioneuroma in one patient. All patients underwent single-stage removal of dumbbell tumors by a posterior approach followed by laminectomy and costotransversectomy combined with instrumentation. Clinical and radiologic outcomes were reviewed, thereafter.
  
  
  RESULTS
  Operative time ranged from 185 to 420 minutes (mean, 313 minutes), with estimated blood loss ranging from 71 to 1830 mL (mean, 658 mL). Postoperative complications included atelectasis in one case. All patients had tumors successfully removed with no neurological deterioration. Spinal deformities were not observed in any patients at the last follow-up (mean, 52 months), with instrumentation.
  
  
  CONCLUSIONS
  Single-stage surgery with laminectomy and costotransversectomy may be useful for removing thoracic dumbbell tumors without a combined anterior approach.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya Graduate University School of Medicine, 65 Tsurumai Syowa-ward, Aichi 466-8550, Japan. keikeiando@hotmail.co.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Ando
authors.forename: Shiro
authors.initials: S
authors.lastname: Imagama
authors.forename: Norimitsux
authors.initials: N
authors.lastname: Wakao
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hirano
authors.forename: Ryoji
authors.initials: R
authors.lastname: Tauchi
authors.forename: Akio
authors.initials: A
authors.lastname: Muramoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsui
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007796:Laminectomy; D008297:Male; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*