The use of tube retractor system in patients with spinal intradural pathologies

Theme: Radiation Oncology in Neurosurgical PracticeFree Paper IV – Spine and General NeurosurgeryOBJECTIVE: To review the use of the tube retractor system in operating various spinal intradural pathologies and the corresponding operative outcome parameters. METHOD: Through a retrospective review of our operative database, patients who had undergone spinal surgeries between May 2011 and August 2012 using the minimally invasive approach with aid of the tube retractor system (Medtronic) were identified. We analyzed various endpoints including completeness of resection, operative time, blood loss, postoperative complications and length of hospitalization. RESULTS: 11 patients were included in this study, where 8 patients were with spinal neoplasms (1 cervical, 1 thoracic, 6 lumbar neoplasms), and one of each with spinal arteriovenous fistula, tethering of cord and retained lumbro-peritoneal shunt proximal catheter. The mean operative time was 177 minutes, blood loss 12.5ml and in-patient stay 6 days postoperatively. Total resections were achieved in all of the 8 cases with spinal tumors. All patients showed improvements in symptoms compared with preoperative status, with no patients developed any postoperative complications. CONCLUSION: Spinal intradural pathologies such as tumors and arteriovenous fistulas could be safely approached with minimally invasive means using the tube retractor system. We hope for further improvement in different technical modalities as our experiences grow with time.link_to_OA_fulltex