Minimally Invasive Versus Open Surgery for Intradural Extramedullary Spinal Cord Tumors: A Critical Analysis
10.21182/jmisst.2025.02159
- Author:
G. BALAMURALI
1
;
Soma Sundar SUBRAMANIAN
;
Keerthivasan PANNEERSELVAM
;
Satish VENUGOPAL
Author Information
1. Kauvery Spine Institute, Kauvery Hospital, Chennai, India
- Publication Type:Original Article
- From:
Journal of Minimally Invasive Spine Surgery and Technique
2025;10(Suppl 2):S150-S162
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Minimally invasive surgery (MIS) has attracted increasing interest for the excision of intradural extramedullary (IDEM) spinal cord tumors. While open surgery is associated with excellent rates of gross total resection (GTR), minimal neurological deficits, and favorable quality of life outcomes, MIS provides potential benefits including reduced morbidity, less postoperative pain, decreased tissue damage, reduced blood loss, and accelerated recovery. This study aimed to evaluate the efficacy of MIS compared to open techniques for IDEM tumor excision by analysing clinical outcomes and procedural advantages.
Methods:This retrospective study included 80 patients who underwent surgery for IDEM tumors by a single surgeon between 2012 and 2019. Outcomes between MIS and open surgery were compared. Assessed parameters included intraoperative blood loss, operative duration, tumor location, postoperative visual analogue scale (VAS) scores, length of hospital stay, and time to return to work. The primary outcomes were GTR rates and complications; secondary outcomes comprised symptom relief and tumor recurrence. All patients were followed for at least 3 years. Statistical analysis was performed to evaluate differences between groups.
Results:Of the 80 patients, 38 underwent MIS and 42 underwent open surgery. MIS was associated with significantly reduced blood loss (65 mL vs. 240 mL, p<0.01) and shorter hospital stays (4.4 days vs. 6.8 days, p<0.01). Although operative times were initially longer for MIS (160 minutes vs. 130 minutes), this was attributed to the learning curve. GTR rates were similar between the groups (94.6% MIS vs. 96.4% open, p=0.46). There were no significant differences in rates of cerebrospinal fluid leak, infection, or neurological complications (p=0.32). Postoperative VAS scores showed significant improvement at 1 and 3 months in the MIS group, but differences were no longer evident at 1 year. No patient in either group required revision surgery within 3 years (p=0.33).
Conclusion:MIS for IDEM tumor excision offers distinct advantages over open surgery, including reduced morbidity and faster recovery, while achieving comparable long-term outcomes. With the implementation of advanced MIS techniques, results equal or surpass those of traditional open approaches.
