Feasibility of unilateral hemilaminectomy utilizing a Williams retractor for the resection of intradural-extramedullary spinal neoplasms - 27/07/21
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ABSTRACT |
Background: While open approaches have historically been used in the surgical treatment of intradural-extramedullary spine tumors, minimally-invasive surgical (MIS) techniques are frequently applied to minimize post-operative complications associated with open surgery. Tubular retractor systems in particular have been employed in combination with the unilateral hemilaminectomy (UHL) approach. Here we describe the use of a Williams retractor as a safe and effective minimally-invasive alternative to tubular retractor systems with similar post-operative outcomes.
Methods: We retrospectively reviewed a cohort of eight patients who underwent unilateral hemilaminectomy using a Williams retractor for the minimally-invasive resection of intradural-extramedullary neoplasms at a large tertiary academic center from 2017 to 2019. Patient demographics, pathologic specimens, radiographic studies, and intraoperative parameters were collected and analyzed.
Results: In our series, gross total resection was achieved in all cases. Average operative time was 158 ± 40 minutes, the mean estimated blood loss (EBL) was 44.4 ± 30.4 mL, and mean length of stay was three days. All patients reported symptomatic improvement at follow-up as reported by Visual Analog Scale scores.
Conclusion: A Williams retractor yields similar outcomes with respect to post-operative pain, operative time, and EBL as it maintains the advantages of the UHL approach in the resection of intradural-extramedullary spine tumors while enhancing feasibility and providing significant cost savings.
Le texte complet de cet article est disponible en PDF.Keywords : Unilateral hemilaminectomy, Williams retractor, Tubular retractor, Intradural-extramedullary tumors, Minimally invasive spine
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