title: Minimally invasive transmuscular approach for the treatment of benign intradural extramedullary spinal cord tumours: Technical note and results.
abstract: BACKGROUND
  Minimally invasive surgery has expanded over the past two decades and was initially used for the treatment of lumbar disc herniation. Later, this approach was used to treat other spine pathologies, as well as to perform spinal fusion and extended spinal decompression. In this study, we report our experience regarding the use of a minimal surgical approach in the treatment of intradural extramedullary spinal cord tumours.
  
  
  METHODS
  Between January 2008 and July 2013, 18 patients with an intradural extramedullary tumour were included in the study (13 thoracic, 4 lumbar and one cervical tumours). The mean age was 59 years. We operated on 11 meningiomas, 6 neurinomas and one ependymoma. All patients underwent minimally invasive surgery using a tubular retractor system to perform a hemilaminectomy in order to access the spinal canal. Fifteen patients had a neurological deficit and 7 suffered from radicular pain prior to surgery.
  
  
  RESULTS
  Gross completed resection was performed in all patients. Mean time of surgery was 95 min. Blood loss was less than 200 cc. Fifteen patients out of 18 were able to get up the day after surgery. Mean hospital stay was 6 days. There were no complications.
  
  
  CONCLUSIONS
  A minimal surgical approach using a tubular retractor permits an effective resection of intradural extramedullary tumours. This procedure may be a useful tool to decrease the risk of secondary spine instability and postoperative kyphosis, and could also be used for spinal junctions and in fragile patients.
authors.affiliation: Service de neurochirurgie, CHU La Timone, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Afathi
authors.affiliation: Service de neurochirurgie, CHU La Timone, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Peltier
authors.affiliation: Service de neurochirurgie, CHU La Timone, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: T
authors.initials: T
authors.lastname: Adetchessi
authors.affiliation: Service de neurochirurgie, CHU La Timone, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: T
authors.initials: T
authors.lastname: Graillon
authors.affiliation: Service de neurochirurgie, CHU La Timone, rue Saint-Pierre, 13005 Marseille, France.
authors.forename: H
authors.initials: H
authors.lastname: Dufour
authors.affiliation: Service de neurochirurgie, CHU La Timone, rue Saint-Pierre, 13005 Marseille, France. Electronic address: sfuentes@ap-hm.fr.
authors.forename: S
authors.initials: S
authors.lastname: Fuentes
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: Benign spinal cord tumours; Chirurgie mini-invasive; Minimally invasive spine surgery; Méningiome rachidien; Schwannome rachidien; Spinal ependymoma; Spinal meningioma; Spinal schwannoma; Épendymome