Traditional surgery for spinal tumors involves midline incision, extensive dissection, muscle damage, blood loss, ligament injury, and bone removal, with an elevated risk of complications. In contrast, minimally invasive techniques cause less soft tissue trauma, bleeding, infections, cerebrospinal fluid leaks, while enabling shorter hospital stays, and yielding similar results compared to open surgery. There have been reports of prior studies have reported the full endoscopic excision of small intradural extramedullary tumors. Here we report a case of a large intradural extramedullary tumor treated with a full endoscopic translaminar approach and dural repair.

Endoscopy is becoming popular in the treatment of various spinal conditions. Soft tissue clearance is a challenge in interlaminar endoscopic spine surgery. The first author (KM) has been using monopolar electrosurgery for the last 7 years. Monopolar electrosurgery is efficient, quick, and cost-effective. However, a thorough knowledge of monopolar electrosurgery is required to avoid complications.

STUDY DESIGN: A retrospective study was undertaken to delineate the characteristics of non-traumatic sequestrated epidurally migrated cervical disc prolapse. PURPOSE: To present first case series of eight such cases diagnosed preoperatively and to discuss their magnetic resonance imaging (MRI) characteristics and their management. OVERVIEW OF LITERATURE: Non-traumatic spontaneous migration of the sequestrated disc fragment epidurally behind cervical vertebral body is rare. Only ten cases have been reported in literature. METHODS: Detailed clinico-radiological profiles of these 8 cases are presented. In six cases their clinical picture was suggestive of cervical myelopathy. MRI scan showed single level epidural migrated disc behind body of C4, C6, and C7 in six patients and two cases with multiple levels (C5-C6). In six cases, anterior corpectomy with excision of the disc was performed and the seventh patient underwent dorsal laminectomy. The eighth patient chose not to undergo surgery. RESULTS: T1 images of the MRI scan showed an isointense signal in all the 8 cases. T2 images revealed a varying intensity. In six cases who underwent anterior corpectomy, there was a rent in the posterior longitudinal ligament. Among those in two cases multiple disc fragments were seen. In the rest four cases, a single large fragment was observed. These patients improved after anterior corpectomy and disc excision. There was no improvement in the patient who had undergone dorsal laminectomy. The eighth patient who refused surgery progressively deteriorated. CONCLUSIONS: We opine that MRI scan especially T1 images are useful in these cases. We prefer to treat these cases through anterior corpectomy with excision of the sequestrated disc which proved to result in excellent outcome.
Humans ; Laminectomy ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Cord Diseases