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Spine and spinal cord tumor surgery: advanced treatment concept
EANS Academy. Asyutin D. Sep 27, 2019; 275999; EP04143
Abstract
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Interest of spinal surgeons to MIS technology in spinal cord tumor surgery is increasing. Besides that management of patients with spinal cord tumors became a very popular direction of research.
Objective: to demonstrated the advantages of using a minimally invasive approach for surgical treatment of intradural extramedullary spinal cord tumor.
Methods: In Burdenko Neurosurgical Center between 2016 and 2018, 178 patients underwent surgical removal of intradural extramedullary spinal cord tumor. Patients with most common spinal cord tumors were include in research. But with size (not more than two segments) and localization limitation (no ventral tumors on cervical and thoracic level). Mean patient age was 47.2 years. Mean follow-up was 22.2 months. Patients were divided into 2 groups: Group I consisted of 86 patients operated with classic open surgical approach was treated according to standard protocol; Group II consisted of 92 patients who were treated using MIS technology with FAST-TRACK protocol.
Results: Group II presented with a lower VAS score (mean difference between groups was 4 points), lower analgesic consumption, shorter hospital stay (mean hospital stay for group I - 6 days, for group II - 4 days) and with the same percentage of total resection and Frankel score. MIS surgery provides up to 30 minutes of median time economy, and blood loss was significantly less. A two times shorter hospital stay and a better patients satisfaction were significant attainment. The result on VAS scale assessment were significant. But there were no significant difference between
other neurological disorders. There is no increase of complication rates due to MIS surgery, but early mobilization provides greatest clinical effect.
Conclusions: Using MIS-surgery in combination with FAST-TRACK recovery protocol on condition of differentiated patient selection provides better quality, safety, lower risk of complications and higher cost effectiveness.
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