Analysis Of Techniques And Curative Effect Of Minimally Invasive Surgery On Intraspinal Extramedullary Subdural Tumors

Object: Under the premise of ensuring surgical quality, surgeons seek to perform operations in a more minimally invasive manner with fewer complications. In current operations, although intraspinal extramedullary subdural tumors are entirely removed by laminectomy, a series of complications would occur, such as CSFL(cerebrospinal fluid leak), infection, LTBP(long term of back pian), and kyphosis. In this trial, we bluntly separated muscles layer by layer by placing an auxiliary pathway, acquired field of operation with less exposure, and most importantly, witnessed no obvious complications after tumors were removed.Method: After conducting retrospective analysis and collecting cases, we selected 50 suitable patients who received treatment from 2015 to 2019. Among them, 21 underwent MIS(minimally invasive surgery), while 29 traditional surgery as the open group; 24 had tumors in the thoracic spine, while 26 had tumors in the lumbar spine. Surgeons used tubular retractor system and surgical operation microscope for the MIS group, and traditional open laminectomy plus surgical operation microscope for the open group. We collected data about the 50 patients, including operative blood loss, length of operation, pre- and post-operative VAS(visual analogue scale) score, JOA(Japanese Orthopaedic Association) score, and complications.Results: Tumors of patients in both groups were totally resected. Statistics show patients in the open group underwent 266.8 +/- 46.3 min of operation, lost 343.1 +/- 80.9 ml of blood, and received follow-up care for 1 to 3 years (1 year on average), among whom 3 experienced CSFL, 4 wound infection, 2 effusion, 4 LTBP, and 4 kyphosis, while those in the MIS group received 113.3 +/- 27.9 min of operation, lost 148.8 +/- 63.9 ml of blood, and received follow-up care for 1 to 2 years (1 year on average), among whom only 1 suffered from CSFL and 1 from wound infection. The JOA and VAS scores of the two groups of patients from admission to discharge till the end of follow-up care also show differences between the two groups.Conclusions: MIS can safely and effectively remove extramedullary subdural tumors in the spinal canal without increasing the risk of nerve damage. All patients in the MIS group were hospitalized for a shorter period after operation, lost less blood, had shorter length of operation, embraced less risk of complications, and obtained good results in follow-up care, which showed that MIS is safe and reliable.