AIM: To examine a series of surgically treated spinal arachnoid cysts in light of the literature.MATERIAL and METHODS: This was a retrospective study of patients treated in the Istanbul Umraniye Training and Research Hospital Neurosurgery Clinic. A total of 18 patients with spinal arachnoid cysts underwent surgical treatment between January 2012 and December 2019. All patients were assessed before and after surgery for muscle strength, pain, sensory changes, and bowel- bladder symptoms. All patients underwent magnetic resonance imaging and computed tomography for diagnosis and treatment.RESULTS: Among the 18 patients, 8 were men and 10 were women, with a mean age of 43.7 (25-66) years. Congenital conditions were discovered in 15 of the patients, 2 after lumbar drainage and 1 after spinal anesthesia. Intradural extramedullary and intra-extradural cysts were found in 17 patients and 1 patient, respectively. The cyst was smaller than level 3 in 14 patients and greater than level 3 in 4 patients. Cyst excision and cyst fenestration were performed in 11 and 7 patients, respectively. Cyst excision was performed in four of the patients who underwent cyst fenestration because their complaints did not improve.CONCLUSION: Surgery should be considered in patients with symptomatic spinal arachnoid cysts. Fenestration may be a suitable alternative, especially if magnetic resonance imaging reveals no intracystic adhesion or trabeculation. Residual and recurrence rates are high in patients with a history of intradural intervention, adhesions, or trabeculation. When there is trabeculation, the best option is cyst removal.
Objective: The aim of this study was to report the results of percutaneous vertebroplasty in managing symptomatic osteolytic cervical spine tumors. Methods: This study comprised a retrospective examination of patients who received percutaneous vertebroplasty between 2008 and 2020 for the treatment of tumor-induced symptomatic cervical vertebra involvement. The study summarized the demographics, vertebral levels, pain control rates, clinical results, and complications of percutaneous vertebroplasty using an anterolateral approach. Results: The study sample consisted of 6 female and 2 male patients aged between 20 and 56 (mean=41.37) years. Tumors were located at C2 in 6 cases, at C3 in 1 case, and at C5 in another. The mean volume of poly (methyl methacrylate) injected was 1.5 mL (range: 1-2 mL). Biopsy results showed the presence of metastasis in 5 cases and plasmacytoma in 3. No postoperative complications or mortality were observed after the procedure. Preoperative mean 7.75 visual analog scale score decreased to 2.62. Pain control was reported to be 66.2%. Conclusion: Anterolateral cervical vertebroplasty seems to be a safe, effective, and helpful therapeutic alternative for the treatment of cervical spine tumors. It reduces the risk of infection compared to the transoral method. Level of Evidence: Level IV, Therapeutic Study Cite this article as: Ramazanoğlu AF, Sarıkaya C, Etli MU, Yaltırık CK, Önen MR, Naderi S. Results of percutaneous cervical vertebroplasty using an anterolateral approach for cervical spine tumors. Acta Orthop Traumatol Turc. 2022;56(4):268-271.
13 March 2023 in Journal of Neurological Surgery Part A: Central European Neurosurgery
Background The current standard of care for spinal schwannoma, which is the most common nerve sheath tumor, is total microsurgical resection. The localization, size, and relationship with the surrounding structures of these tumors are crucial in terms of preoperative planning. A new classification method for surgical planning of spinal schwannomas is presented in this study. Methods All patients who underwent surgery for spinal schwannoma between 2008 and 2021 were reviewed retrospectively, along with radiologic images, clinical presentation, surgical approach, and postoperative neurologic status. Results A total of 114 patients (57 males and 57 females) were included in the study. Tumor localizations were cervical in 24 patients, cervicothoracic in 1 patient, thoracic in 15 patients, thoracolumbar in 8 patients, lumbar in 56 patients, lumbosacral in 2 patients, and sacral in 8 patients. All tumors were divided into seven types according to our classification method. Type 1 and 2 groups were operated on with a posterior midline approach only, type 3 tumors were operated on with a posterior midline approach and an extraforaminal approach, and type 4 tumors were operated on with only an extraforaminal approach. While the extraforaminal approach was sufficient in patients with type 5 tumors, partial facetectomy was required in 2 patients. A combined surgery including hemilaminectomy and extraforaminal approach was performed in the type 6 group. A posterior midline approach with partial sacrectomy/corpectomy was performed in the type 7 group. Conclusion Effective treatment of spinal schwannoma depends on preoperative planning, which includes correctly classifying tumors. In this study, we present a categorization scheme that covers bone erosion and tumor volume for all spinal localizations.