title: Minimally invasive resection of extradural dumbbell tumors of thoracic spine: surgical techniques and literature review.
abstract: Dumbbell-shaped thoracic tumors represent a distinct type of tumor and involve in both the spinal canal and the posterior thoracic cavity. Successful treatment for the tumors depends on gross total resection (GTR) via an open laminectomy and facetectomy or transthoracic transpleural approach. In this case series, we report our experiments with minimally invasive method for the removal of extradural dumbbell thoracic tumor and present related literature review.
  
  
  
  We retrospectively reviewed two patients with dumbbell-shaped thoracic tumors who underwent minimally invasive resection and unilateral transforaminal thoracic intervertebral fusion (TTIF) through unilateral paraspinal muscle approachwith a spotlight expandable tubular retractor. Clinical data, tumor characteristics, and outcomes were analyzed.
  
  
  
  Two patients underwent successful minimally invasive treatment of their spinal neoplasms. There were no procedure-related complications. The efficacy in terms of neurological recovery, pain improvement and operative variables (length of incision, operative duration, blood loss, and hospital stay) was better when compared with prior published studies. Postoperative CT image demonstrated complete resection of dumbbell tumor in the patients. The solid fusion was obtained after 3 months follow-up and there was no failure of internal fixation.
  
  
  
  If the medial border of intracanal component of extradural dumbbell tumor is near the midline of canal and the pedicles of adjacent vertebrae to tumor are intact, minimally invasive resection of tumor through unilateral paraspinal muscle approach combined with unilateral TTIF is good choice.
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Chunbo
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Zhenjiang Hospital of Traditional Chinese and Western Medicine, Zhenjiang, 212000, Jiangsu, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai, 180 Fenglin Road, Shanghai, 200032, China. 447574313@qq.com.
authors.forename: Yutong
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Dong
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015174:Epidural Neoplasms / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D007796:Laminectomy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D013115:Spinal Canal / Q000601:surgery*; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods; D013125:Spinal Neoplasms / Q000150:complications / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*; D035441:Thoracic Wall / Q000601:surgery
keywords: Dumbbell-shaped tumor; Minimally invasive surgery; Pedicle screw fixation; Surgical techniques; Transforaminal thoracic intervertebral fusion