The results of surgical treatment of dumbbell tumors of the lumbosacral spine

INTRODUCTION . Surgical treatment of dumbbell tumors of the lumbar spine remains a discussible topic due to its complex location, affecting three conventional anatomical zones: the spinal canal, retroperitoneal space and foraminal canal. Many publications on the advantages and disadvantages of various treatment methods prove the need to develop a personalized approach to solving this issue. MATERIALS AND METHODS . The data of 47 (100 %) patients operated on for dumbbell tumors of the lumbosacral spine at the Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre in the period from 2015 to 2020 were analyzed, divided into 3 study groups operated using: tubular retractor – 16 (34.4 %), Kaspar wound expander – 15 (31.2 %), Quadrant® wound expander – 16 (34.4 %). The average age of the patients was 48.7 (19–76 years), among them 27 (57.45 %) women and 20 (42.55 %) men. Access to the tumor and its resection were performed using a tubular retractor or a Kaspar wound expander by one surgical team. Patients were observed both face-to-face, with an assessment of neurological status, after 6 and 12 months, and remotely – an analysis of MRI studies after 3, 6, 12, 24 and 36 months. RESULTS . The average surgical intervention time in the tubular retractor group was 125 min, in the Kaspar wound dilator group – 148 min, in the Quadrant® wound dilator group – 134 min, the average blood loss was comparable in both groups and amounted to 210 (80–400 ml). Total tumor resection was achieved in 100 % of cases. The average duration of hospitalization was 6 days. Histological verification of the tumor tissue revealed a 3-to-1 ratio of schwannomas to neurofibromas (35 (74.47 %) schwannomas and 12 (25.53 %) neurofibromas). There was no recurrence of the tumor during the follow-up period. CONCLUSION . Dumbbell tumors of the lumbosacral region can be removed in one step, completely and safely for the patient using minimally invasive methods, regardless of the surgical access technique used.