Percutaneous Full-Endoscopic Removal of Lumbar Intradural Extramedullary Tumor via Translaminar Approach.

Abstract

Despite the fact that technologic advances and surgical experience expand the use of endoscope in spinal surgery, there are few reports on its application in the management of spinal tumors. We present a case report of intradural extramedullary tumor excision with the percutaneous full endoscopic translaminar approach. A 67-year-old male presented to our clinic with lumbar, left thigh pain and paresthesia in both thighs. Preoperative magnetic resonance imaging revealed a contrast-enhanced intradural extramedullary mass with benign characteristics on L1 with the preliminary diagnosis of meningioma. The percutaneous translaminar endoscopic approach was planned to remove the intradural extramedullary tumor from a 7-mm skin incision. Surgery was planned in 4 stages: 1) exposure of the dura by opening a window on the lamina, 2) opening and expanding of the dura, 3) exposure of all sides of the tumor, and 4) excision of the tumor and hemostasis. Closing the dura and ending the surgery. This report supports that full endoscopic spinal intradural extramedullary mass excision may give good results in selected cases and in experienced hands.