Uncommon Intradural–Extramedullary Lesions Removed by Uniportal Minimally Invasive Technique. Clinical and Radiological Results: A Study with 12 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 fusion. Patients and Methods We present four patients (one woman and three men) with symptoms including 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.). We measured a VAS, Nurick scales pre-op, and with follow-up of 6 weeks, 3.6 and 12 months post-op. Surgical time, blood loss and time to discharge. All the patients underwent control MRI postoperatively. Results One patient neurenteric cyst, two patients: underwent neurocysticercosis, and the last epidermoid cyst. The VAS and Nurick scales were decreased over the time line. The surgical time was 140 minutes (mean), blood loss 30 mL (mean). All the patients were discharged at 47 hours 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.