Surgical management of paraspinal tumors

Abstract

Objective: Paraspinal tumors are uncommon and surgically challenging. We reviewed 26 consecutive cases of paraspinal tumors to evaluate clinical features and surgical approaches. Materials and methods: All patients with paraspinal tumors who underwent surgery at our institute between 1998 and 2004 were retrospectively analyzed. Radiologic examinations and medical records were reviewed and additional follow-up information was obtained by telephone interview. Mean follow-up period was 2.5 years. Results: Incidence of paraspinal tumor was 6.2%(26 cases of 417 spinal tumors reported during the same period). The most frequent pathology was schwannoma(n=15) followed by neurofibroma(n=4). Back pain was the most common presenting symptom. Anatomical characteristics of paraspinal tumors including size and location made it difficult to expose themselves by classic posterior approach. Surgical resection was via anterior cervical or periclavicular(n=6), retroperitoneal(n=6), posterior(n=5), transperitoneal(n=2), lateral extracavitory(n=2), transthoracic(n=1) approaches and two-stage combined operations(n=4). Total removal could be achieved in 23 patients(88%). Tumor recurrence was noted in 3 cases during follow-up. Conclusions:The surgical approach of paraspinal tumors is determined by location, size, neoplastic nature, and spinal canal involvement. Paraspinal tumors can be safely managed by surgery.