One step excision combined with unilateral transforaminal intervertebral fusion

Introduction: Spinal dumbbell-shaped tumors are rare, usually benign tumors with intraspinal and paravertebral components connected through intervertebral foramen. Complete excision is often performed through traditional open surgery (TOS). The efficacy and long-term outcomes of minimally invasive surgery (MIS) have not been reported to date in resection of dumbbell-shaped spinal tumors. Purpose: The purpose was to evaluate the efficacy and long-term outcomes of minimally invasive resection combined with unilateral transforaminal intervertebral fusion (TIF) through comparing with TOS in the treatment of spinal dumbbell-shaped tumors. Methods: Fifteen patients underwent MIS and 18 patients underwent TOS. Thoracic dumbbell-shaped tumors were directly exposed after removal of costotransverse joints, adjacent rib components, unilateral hemilamina, and facet joints. Lumbar dumbbell-shaped tumors were completely exposed after removal of transverse processes, unilateral hemilamina, and facet joints. Whether for minimally invasive resection or traditional open removal, dumbbell-shaped tumors were completely excised and unilateral TIF was performed to guarantee spinal stability. All patients were followed up for 5 years at least. Results: The mean length of surgical incision for two groups was 3.47 ± 0.37 vs. 6.49 ± 0.39 cm ( Conclusions: Spinal dumbbell-shaped tumors can be safely and effectively treated with minimally invasive resection combined with unilateral TIF. Compared with TOS, MIS offers a reduced length of surgical incision, blood loss, hospital stay, and postoperative pain. This surgical protocol might provide an alternative for the treatment of spinal dumbbell-shaped tumors.