Introduction: Excision of Spinal tumors traditionally been with open methods with laminectomy.Tubular Retractors have been used for many conditions for Minimal Access spine surgery.Using Tubular retractors to access spinal tumors is the new advancement in spinal surgery.I present my experience with excision of spinal tumors with Tubular retractors.
Methods: Retrospective and prospective analysis of 48 patients with spinal tumors excised with tubular retractors.Outcome measures includes VAS,Modified MacNab score and oswestry Disability index.Incidence of residual tumor was noted.
Results: 48 patients were included in the study who were followed up for minimum of 6 months.30 had ibtradural extramedullary tumors,15 had extramedullary tumors and 3 had intramedullary tumors.Most of the tumors were in thoracic region.The average operating time with tubular retractor system was 90.5 (range 60-250) minutes.Length of stay in the present study was about 3 days (2-6 days). The average size of incision was about 2.4 (range 2.0-3.5) centimeters. The average follow-up time is 8 months. The VAS score of back pain was significantly low. The ODI score was significantly improved at 1st month post-operation . The complication rate was about 9.5% (4 patients) and the residual tumor that need to re-operation rate was about 4.9% (2 patients).No patient had Infection or CSF leak or psuedomeningocele.
Conclusions: Most of IDEM extradural tumors which extend upto 2 level can be excised using tubular retractors.
Postoperative instability and requirement of stabilization is nil.
CSF leak or pseudomeningocele can be reduced.
Learning curve is quite steep.
Patient Care: Management of spinal tumors using tubular retractors will definitely decrease post operative pain and CSF complications.
Learning Objectives: Spinal tumours can be excised without doing full laminectomy.
Post op pain and CSF complications can be reduced significantly using tubular retractors.