A novel lateral myelotomy approach for the treatment of lateral or ventrolateral spinal gliomas
Objective To describe a novel surgical approach in which myelotomy was performed lateral to the dorsal root entry zone (LDREZ), for the treatment of lateral or ventrolateral spinal intramedullary glioma. Methods This study reviewed six patients with lateral or ventrolateral spinal intramedullary gli...
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| Veröffentlicht in: | Acta neurochirurgica 2024-05, Vol.166 (1), p.237-237, Article 237 |
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| creator | Hang, Gai Gong, Yukang Xie, Hang Xie, Tianhao |
| description | Objective
To describe a novel surgical approach in which myelotomy was performed lateral to the dorsal root entry zone (LDREZ), for the treatment of lateral or ventrolateral spinal intramedullary glioma.
Methods
This study reviewed six patients with lateral or ventrolateral spinal intramedullary glioma who received surgical treatments by using myelotomy technique of LDREZ approach. The patient’s clinical characteristics, magnetic resonance imaging (MRI) results, and follow-up outcomes were analyzed. The neurological function of patients before and after operation was assessed based on the Frankel scale system. The anatomical feasibility, surgical techniques, advantages and disadvantages of LDREZ approach were analyzed.
Results
Myelotomy technique of LDREZ approach was employed in all 6 patients. Gross total resections were achieved in 4 patients, and 2 patients with astrocytoma (case 2, 6) underwent partial removal. The perioperative recovery was all smooth and all the patients were discharged on schedule. All the patients who suffered from neuropathic pain were relieved. After surgery, neurological function remained unchanged in 3 patients. 2 patients improved from Frankel grade B to C, and 1 patient deteriorated from Frankel grade D to C immediately after surgery and returned to Frankel grade D at 3 months follow-up. Regarding to the poor prognosis of high-grade glioma, the two cases with WHO IV glioma didn’t achieve long survival.
Conclusion
LDREZ approach is feasible and safe for the surgical removal of lateral or ventrolateral spinal gliomas. This approach can provide a direct pathway to lateral or ventrolateral spinal gliomas with minimal damage to normal spinal cord. |
| doi_str_mv | 10.1007/s00701-024-06139-2 |
| format | Article |
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To describe a novel surgical approach in which myelotomy was performed lateral to the dorsal root entry zone (LDREZ), for the treatment of lateral or ventrolateral spinal intramedullary glioma.
Methods
This study reviewed six patients with lateral or ventrolateral spinal intramedullary glioma who received surgical treatments by using myelotomy technique of LDREZ approach. The patient’s clinical characteristics, magnetic resonance imaging (MRI) results, and follow-up outcomes were analyzed. The neurological function of patients before and after operation was assessed based on the Frankel scale system. The anatomical feasibility, surgical techniques, advantages and disadvantages of LDREZ approach were analyzed.
Results
Myelotomy technique of LDREZ approach was employed in all 6 patients. Gross total resections were achieved in 4 patients, and 2 patients with astrocytoma (case 2, 6) underwent partial removal. The perioperative recovery was all smooth and all the patients were discharged on schedule. All the patients who suffered from neuropathic pain were relieved. After surgery, neurological function remained unchanged in 3 patients. 2 patients improved from Frankel grade B to C, and 1 patient deteriorated from Frankel grade D to C immediately after surgery and returned to Frankel grade D at 3 months follow-up. Regarding to the poor prognosis of high-grade glioma, the two cases with WHO IV glioma didn’t achieve long survival.
Conclusion
LDREZ approach is feasible and safe for the surgical removal of lateral or ventrolateral spinal gliomas. This approach can provide a direct pathway to lateral or ventrolateral spinal gliomas with minimal damage to normal spinal cord.</description><identifier>ISSN: 0942-0940</identifier><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-024-06139-2</identifier><identifier>PMID: 38809310</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Adult ; Aged ; Astrocytoma ; Cordotomy - methods ; Dorsal roots ; Female ; Glioma ; Glioma - diagnostic imaging ; Glioma - surgery ; Humans ; Interventional Radiology ; Magnetic Resonance Imaging ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgery ; Neuralgia ; Neurology ; Neuroradiology ; Neurosurgery ; Neurosurgical anatomy ; Neurosurgical Procedures - methods ; Patients ; Spinal cord ; Spinal Cord Neoplasms - diagnostic imaging ; Spinal Cord Neoplasms - surgery ; Surgery ; Surgical Orthopedics ; Technical Note ; Treatment Outcome</subject><ispartof>Acta neurochirurgica, 2024-05, Vol.166 (1), p.237-237, Article 237</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2024</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2024.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-7a9326ffc3c77e9e44fbbd7e9da99880313df60d71405a48a5683733e006e67e3</cites><orcidid>0009-0008-5703-2608 ; 0009-0004-5189-4320 ; 0009-0007-7118-706X ; 0000-0002-3669-5495</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00701-024-06139-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00701-024-06139-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38809310$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hang, Gai</creatorcontrib><creatorcontrib>Gong, Yukang</creatorcontrib><creatorcontrib>Xie, Hang</creatorcontrib><creatorcontrib>Xie, Tianhao</creatorcontrib><title>A novel lateral myelotomy approach for the treatment of lateral or ventrolateral spinal gliomas</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>Objective
To describe a novel surgical approach in which myelotomy was performed lateral to the dorsal root entry zone (LDREZ), for the treatment of lateral or ventrolateral spinal intramedullary glioma.
Methods
This study reviewed six patients with lateral or ventrolateral spinal intramedullary glioma who received surgical treatments by using myelotomy technique of LDREZ approach. The patient’s clinical characteristics, magnetic resonance imaging (MRI) results, and follow-up outcomes were analyzed. The neurological function of patients before and after operation was assessed based on the Frankel scale system. The anatomical feasibility, surgical techniques, advantages and disadvantages of LDREZ approach were analyzed.
Results
Myelotomy technique of LDREZ approach was employed in all 6 patients. Gross total resections were achieved in 4 patients, and 2 patients with astrocytoma (case 2, 6) underwent partial removal. The perioperative recovery was all smooth and all the patients were discharged on schedule. All the patients who suffered from neuropathic pain were relieved. After surgery, neurological function remained unchanged in 3 patients. 2 patients improved from Frankel grade B to C, and 1 patient deteriorated from Frankel grade D to C immediately after surgery and returned to Frankel grade D at 3 months follow-up. Regarding to the poor prognosis of high-grade glioma, the two cases with WHO IV glioma didn’t achieve long survival.
Conclusion
LDREZ approach is feasible and safe for the surgical removal of lateral or ventrolateral spinal gliomas. This approach can provide a direct pathway to lateral or ventrolateral spinal gliomas with minimal damage to normal spinal cord.</description><subject>Adult</subject><subject>Aged</subject><subject>Astrocytoma</subject><subject>Cordotomy - methods</subject><subject>Dorsal roots</subject><subject>Female</subject><subject>Glioma</subject><subject>Glioma - diagnostic imaging</subject><subject>Glioma - surgery</subject><subject>Humans</subject><subject>Interventional Radiology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgery</subject><subject>Neuralgia</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Neurosurgical anatomy</subject><subject>Neurosurgical Procedures - methods</subject><subject>Patients</subject><subject>Spinal cord</subject><subject>Spinal Cord Neoplasms - diagnostic imaging</subject><subject>Spinal Cord Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Technical Note</subject><subject>Treatment Outcome</subject><issn>0942-0940</issn><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1PwzAMhiMEYmPwBzigSFy4FJyPNu1xmviSkLjAOcpad-vUNiXpJu3fE-g2EAcutmU_fm29hFwyuGUA6s6HACwCLiNImMgifkTGkEkehQDHv-oROfN-BcC4kuKUjESaQiYYjIme0tZusKa16dGZmjZbrG1vmy01XeesyZe0tI72S6S9Q9M32PbUlgc-zDah5ey-4buqDWlRV7Yx_pyclKb2eLHLE_L-cP82e4peXh-fZ9OXKOdx0kfKZIInZZmLXCnMUMpyPi9CVZgsC88KJooygUIxCbGRqYmTVCghECDBRKGYkJtBN_z8sUbf66byOda1adGuvRbBIZVKoSCg13_QlV278PNAxcBjKQPFByp31nuHpe5c1Ri31Qz0l_16sF8H-_W3_ZqHpaud9HreYHFY2fsdADEAPozaBbqf2__IfgI9Fo_X</recordid><startdate>20240529</startdate><enddate>20240529</enddate><creator>Hang, Gai</creator><creator>Gong, Yukang</creator><creator>Xie, Hang</creator><creator>Xie, Tianhao</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0008-5703-2608</orcidid><orcidid>https://orcid.org/0009-0004-5189-4320</orcidid><orcidid>https://orcid.org/0009-0007-7118-706X</orcidid><orcidid>https://orcid.org/0000-0002-3669-5495</orcidid></search><sort><creationdate>20240529</creationdate><title>A novel lateral myelotomy approach for the treatment of lateral or ventrolateral spinal gliomas</title><author>Hang, Gai ; Gong, Yukang ; Xie, Hang ; Xie, Tianhao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-7a9326ffc3c77e9e44fbbd7e9da99880313df60d71405a48a5683733e006e67e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Astrocytoma</topic><topic>Cordotomy - methods</topic><topic>Dorsal roots</topic><topic>Female</topic><topic>Glioma</topic><topic>Glioma - diagnostic imaging</topic><topic>Glioma - surgery</topic><topic>Humans</topic><topic>Interventional Radiology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgery</topic><topic>Neuralgia</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Neurosurgical anatomy</topic><topic>Neurosurgical Procedures - methods</topic><topic>Patients</topic><topic>Spinal cord</topic><topic>Spinal Cord Neoplasms - diagnostic imaging</topic><topic>Spinal Cord Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Technical Note</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hang, Gai</creatorcontrib><creatorcontrib>Gong, Yukang</creatorcontrib><creatorcontrib>Xie, Hang</creatorcontrib><creatorcontrib>Xie, Tianhao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hang, Gai</au><au>Gong, Yukang</au><au>Xie, Hang</au><au>Xie, Tianhao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A novel lateral myelotomy approach for the treatment of lateral or ventrolateral spinal gliomas</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2024-05-29</date><risdate>2024</risdate><volume>166</volume><issue>1</issue><spage>237</spage><epage>237</epage><pages>237-237</pages><artnum>237</artnum><issn>0942-0940</issn><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Objective
To describe a novel surgical approach in which myelotomy was performed lateral to the dorsal root entry zone (LDREZ), for the treatment of lateral or ventrolateral spinal intramedullary glioma.
Methods
This study reviewed six patients with lateral or ventrolateral spinal intramedullary glioma who received surgical treatments by using myelotomy technique of LDREZ approach. The patient’s clinical characteristics, magnetic resonance imaging (MRI) results, and follow-up outcomes were analyzed. The neurological function of patients before and after operation was assessed based on the Frankel scale system. The anatomical feasibility, surgical techniques, advantages and disadvantages of LDREZ approach were analyzed.
Results
Myelotomy technique of LDREZ approach was employed in all 6 patients. Gross total resections were achieved in 4 patients, and 2 patients with astrocytoma (case 2, 6) underwent partial removal. The perioperative recovery was all smooth and all the patients were discharged on schedule. All the patients who suffered from neuropathic pain were relieved. After surgery, neurological function remained unchanged in 3 patients. 2 patients improved from Frankel grade B to C, and 1 patient deteriorated from Frankel grade D to C immediately after surgery and returned to Frankel grade D at 3 months follow-up. Regarding to the poor prognosis of high-grade glioma, the two cases with WHO IV glioma didn’t achieve long survival.
Conclusion
LDREZ approach is feasible and safe for the surgical removal of lateral or ventrolateral spinal gliomas. This approach can provide a direct pathway to lateral or ventrolateral spinal gliomas with minimal damage to normal spinal cord.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>38809310</pmid><doi>10.1007/s00701-024-06139-2</doi><tpages>1</tpages><orcidid>https://orcid.org/0009-0008-5703-2608</orcidid><orcidid>https://orcid.org/0009-0004-5189-4320</orcidid><orcidid>https://orcid.org/0009-0007-7118-706X</orcidid><orcidid>https://orcid.org/0000-0002-3669-5495</orcidid></addata></record> |
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| ispartof | Acta neurochirurgica, 2024-05, Vol.166 (1), p.237-237, Article 237 |
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| source | MEDLINE; Springer Online Journals Complete |
| subjects | Adult Aged Astrocytoma Cordotomy - methods Dorsal roots Female Glioma Glioma - diagnostic imaging Glioma - surgery Humans Interventional Radiology Magnetic Resonance Imaging Male Medical prognosis Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgery Neuralgia Neurology Neuroradiology Neurosurgery Neurosurgical anatomy Neurosurgical Procedures - methods Patients Spinal cord Spinal Cord Neoplasms - diagnostic imaging Spinal Cord Neoplasms - surgery Surgery Surgical Orthopedics Technical Note Treatment Outcome |
| title | A novel lateral myelotomy approach for the treatment of lateral or ventrolateral spinal gliomas |
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