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Anterior to Dorsal Root Entry Zone Myelotomy (ADREZotomy) A New Surgical Approach for the Treatment of Ventrolateral Deep Intramedullary Spinal Cord Cavernous Malformations

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机构: [1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute, Beijing, China.
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关键词: cavernous malformations dorsal root entry zone intramedullary tumor myelotomy outcome resection spinal cord surgical approach surgical technique vascular malformations

摘要:
Study Design. A retrospective review of prospectively collected data. Objective. To confirm the feasibility of using anterior to dorsal root entry zone myelotomy (ADREZotomy), a new surgical approach, for the treatment of ventrolateral deep intramedullary spinal cord cavernous malformation (ISCCMs). Summary of Background Data. Surgical removal of ventrolateral deep ISCCMs is highly risky and remains problematic. Methods. The authors performed a retrospective study exploring the surgical removal of ventrolateral intrinsic ISCCMs using ADREZotomy in 10 patients. The Frankel grading system was used to evaluate the patients' neurological function at the preoperative, postoperative and follow-up stages. American Spinal Injury Association Scale scores at the preoperative and postoperative were also obtained. The patient characteristics and surgical outcomes were analyzed. The indication, operative steps, complications, and anatomical basis of the myelotomies were described and discussed. Results. In total, nine (90%) patients presented with mild symptoms before surgery. Gross total resections were performed in all 10 patients. Immediately after surgery, the neurological function of eight (80.0%) patients remained the same. One patient improved and one (10%) patient worsened. There were no other immediate or delayed complications related to the surgical procedure. No decrease of total American Spinal Injury Association sensory scores was observed. The follow-up neurological function evaluation showed that two (20%) patients improved from a Frankel grade of D to E and eight (80.0%) patients were stable. No recurrences or other additional neurological deterioration was observed. Conclusion. Surgical removal of ventrolateral deep ISCCMs can be feasible using proper surgical techniques. ADREZotomy is a minimally invasive technique for the removal of cervical and thoracic ventrolateral deep ISCCMs, without disrupting the important spinal cord tracts or the need to broadly expose bone.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 骨科
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 骨科
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出版当年[2016]版:
Q2 CLINICAL NEUROLOGY Q2 ORTHOPEDICS
最新[2023]版:
Q1 ORTHOPEDICS Q2 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute, Beijing, China.
通讯作者:
通讯机构: [*1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute, No. 45 Changchun St, Xicheng District, Beijing 100053, China
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