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.

中文翻译：

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使用威廉姆斯牵开器切除硬膜内-髓外脊髓肿瘤的单侧半椎板切除术的可行性

背景

虽然开放式方法历来用于硬膜内-髓外脊柱肿瘤的手术治疗，但微创手术 (MIS) 技术经常用于最大限度地减少与开放式手术相关的术后并发症。特别是管状牵开器系统已与单侧半椎板切除术 (UHL) 方法结合使用。在这里，我们描述了使用 Williams 牵开器作为管状牵开器系统的安全有效的微创替代方案，具有类似的术后结果。

方法

我们回顾性地回顾了 2017 年至 2019 年在大型三级学术中心接受单侧半椎板切除术使用 Williams 牵开器微创切除硬膜内髓外肿瘤的 8 名患者队列。 患者人口统计学、病理标本、放射学研究和术中参数被收集和分析。

结果

在我们的系列中，所有病例均实现了全切除。平均手术时间为 158  ±  40 分钟，平均估计失血量 (EBL) 为 44.4  ±  30.4  mL，平均住院时间为三天。根据视觉模拟量表评分报告，所有患者在随访时都报告了症状改善。

结论

Williams 牵开器在术后疼痛、手术时间和 EBL 方面产生了类似的结果，因为它保持了 UHL 方法在切除硬膜内-髓外脊柱肿瘤方面的优势，同时提高了可行性并显着节省了成本。