It was reported via journal article title: anatomic basis for minimally invasive resection of intradural extramedullary lesions in thoracic spine authors: luis m.Tumiala´n, nicholas theodore, mohan narayanan, frederick f.Marciano, and peter nakaji.Citation: world neurosurg.(2018) 109:e770-e777; https://doi.Org/10.1016/j.Wneu.2017.10.078.The aim of this retrospective dimensional analysis is to evaluate the result of this analysis to provide an anatomic basis for a minimally invasive approach to intradural extramedullary thoracic spinal lesions.Data from 26 patients with thoracic intradural extramedullary lesions who were managed between 2010 and 2016 with either traditional midline open laminectomy (n =11) or minimally invasive resection (n=15).During the procedure, midline open.Laminectomies were performed at the lesion level and at the levels above and below.The dura was opened in the midline and tacked up with 4.0 nurolon (ethicon, inc., (b)(4)) sutures, and a gross total lesion resection was performed using microsurgical techniques.The dura was closed with running 6.0 prolene (ethicon, inc.) sutures.Dural sealant was then applied to the repair.Seven patients underwent osteoplastic laminoplasty with miniplates, and 4 patients underwent standard laminectomies.One postoperative cerebrospinal fluid leak was noted in 1 patient who had undergone laminoplasty and required an incision and drainage.No cerebrospinal fluid leaks were noted in the minimally invasive group.As mentioned earlier, the only infections were in the laminoplasty group (2 patients).Both required incision and drainage and removal of the lamina and spinous process.In this study, no lesion exceeded the lateral or ap dimensions of the canal.Displacement of the spinal cord to one side by the lesion further favors a hemilaminectomy approach.Exposure of 35 mm in the rostrocaudal dimension and 20 mm in the lateral dimension centered over the lesion offers a safe surgical corridor for resection while preserving the posterior elements, facet complexes, and paraspinal musculature.
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