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• W2387374049 abstract "Objective:To analyze the clinical features,surgical strategy of inner and outer cervical spinal canal dumbbell tumors as well as the effect of three-dimensional classification on surgical strategy.Method:Twenty one patients with inner and outer cervical spinal canal dumbbell tumors from January 2004 to January 2008 were reviewed retrospectively.Based on the tumor site,there were 6 cases in C1/2,4 in C2/3,3 in C3/4,3 in C4/5,2 in C5/6,1 in C6/7,1 in C1/2 and C2/3,1 in C4/5 and C5/6.Of all tumors,there were 14 neurinoma,4 neurofibroma,2 von Recklinghausen disease,1 malignant schwannoma.Based on Toyama classification,there were 1 case of type Ⅰ,4 of type Ⅱa,2 of type Ⅱb,1 of Ⅱc,10 of type Ⅲa,2 of type Ⅲb,1 of type V;19 case of IF stage Ⅰ,2 of IF stage Ⅱ,19 of TF Ⅰ,2 of TF Ⅱ.The operative strategy were determined upon Toyama classification.The mean JOA score was 8.7 for all patients.There were 1 case of B grade,5 of C grade,11 of D grade,4 of E grade based on ASIA scale.Patients with tumors mainly locating in posterior side of spinal canal and not progressing into the intervertebral foramen consisted all type Ⅰ,Ⅱa,Ⅴ and almost all Ⅲa with tumors removed by posterior approach alone in 15 patients except of one patient with type Ⅲa tumor at C1-2 experiencing lateral approach on early stage.4 cases of type Ⅱb and Ⅲ b witth tumor involving the spinal canal and paravertebral region experienced combined posterior and anterior approach,1 case of type Ⅱc with tumor located anteriorly to the cervical spine canal underwent the anterior approach.Reconstruction was performed in 4 patients with bone defect,3 of TF underwent unilateral spinal instrumentation and 1 of IF stage 2 underwent bilateral instrumentation.Neurological function was evaluated by JOA score and AIS grade after operation.Result:The mean follow-up period was 23 months(ranged,6 months to 4 years).All tumors were removed successfully.There were no injury to vertebral artery and deteriorate of neurological function.Pain and neurological deficit relieved significantly.There were 1 case developing transient weakening of upper limb which recovered after 3 days of use of corticosteroids and dehydration.1 case complicating cerebrospinal fluid leakage recovered after conservative management.1 case complicating intracranial infection was cured by simple drainage and anti-infective therapy with no secondary to cervical misalignment.Recurrence were found progressing out of intervertebral foramen in 1 case with type Ⅲa tumor.The mean score of postoperative JOA was 13.2.After operation,there were no case of grade B,1 of grade C,2 of grade D,18 of grade E based on ASIA scale.Complete neurological recovery was noted in 14 cases.Conclusion:Systematic three-dimensional classification is essential for determining surgical strategy and approach,which is beneficial for tumor en bloc removal rate so as to decrease recurrence rate." @default.
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• W2387374049 title "Three-dimensional classification and surgical strategy of inner and outer cervical spinal canal dumbbell tumors" @default.
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