Minimal Invasive Excision of Spinal Tumors using Tubular Retractors. Abhaya Kumar MBBS, MS, FRCS Kokilaben Dhirubhai Ambani Hospital,Mumbai India

Introduction Results Learning Objectives Excision of Spinal intradural extramedullary tumors 48 patients were included in the study who were Spinal tumours can be excised without doing full traditionally been with open methods with wide followed up for minimum of 6 months.30 had laminectomy. laminectomy.Tubular Retractors have been used for intradural extramedullary tumors,15 had Minimal Access spine surgery.Using Tubular extramedullary tumors and 3 had intramedullary retractors to access spinal intradural tumors is the tumors.Most of the tumors were in thoracic Post op pain and CSF complications can be new advancement in spinal surgery.I present my region.The average operating time with tubular reduced significantly using tubular retractors. experience with excision of spinal tumors using retractor system was 90.5 (range 60-250) Tubular retractors. minutes.Length of stay in the present study was References about 3 days (2-6 days). The average size of

Methods incision was about 2.4 (range 2.0-3.5) centimeters. Retrospective and prospective analysis of 48 The average follow-up time is 8 months. The VAS patients with spinal intradural extramedullary score of back pain was significantly low. The ODI tumors excised using tubular retractors.Outcome score was significantly improved at 1st month post- measures includes VAS,Modified MacNab score and operation . The complication rate was about 9.5% oswestry Disability index.Incidence of residual (4 patients) and the residual tumor that need to re- tumor was assesed.Incidence of conversion to open operation rate was about 4.9% (2 patients).No method on table was assesed. patient had Infection or CSF leak or psuedomeningocele.

Conclusions Most of IDEM extradural tumors which extend upto 2 level can be excised using tubular retractors.

Postoperative instability and requirement of stabilization is nil.

CSF leak or pseudomeningocele can be reduced.

Learning curve is quite steep.