Uncommon Intradural-Extramedullary Lesions Removed by Direct Uniportal Minimally Invasive Technique: Clinical and Radiological Results. A Study with 24 Months of Follow-up

Abstract

Introduction Intradural extramedullary cervical lesions usually cause pain or neurological deficit secondary to neural compression. Traditional treatment of these tumors includes standard fashion cut incision, open laminectomy and some cases fusión with a delayed recovery and return to daily activities. Material and Methods We present seven patients (four woman and tree man) with symptoms include radicular pain and/ or neurological deficit, due intradural-extramedullary cervical lesion. All the patients underwent total resection with minimally invasive uniportal technique using a tree blade MAXCESS retractor system (Nuvasive, Inc) and surgical microscope. We measured a VAS, Nurick scales preop and with follow up of 6 weeks, 3,6, 12 and 24 months of follow up. Surgical time, blood loss and time to discharge. All the patients was underwent control MRI postoperatively. Results Histologically report: Two patients neurenteric cyst, four patients: neurocisticercosis and the last: epidermoid cyst. The VAS and Nurick scales was decreased over the time line. The surgical time was 140 minutes mean, blood loss 30cc mean, All the patients was discharged 47hours mean and return to daily activities 10 days mean. Conclusion Intradural-extramedullary lesions can be safely and effectively treated with minimally invasive techniques. Potential reduction in blood loss, hospitalization, disruption to local tissues and return to daily activities suggest that, this technique may present an alternative to traditional open resection with excellent follow up.