What is Endoscopic Removal of Spinal Tumors?
Endoscopic removal of spinal tumors is a minimally invasive surgical technique used to treat tumors (abnormal mass of tissue ) located in or around the spinal cord or spine. This procedure utilizes a small incision, specialized surgical instruments, and an endoscope—a thin tube with a camera and light at the end—to access and remove the tumor with greater precision, reducing trauma to surrounding tissues. It is often considered for tumors that are located in hard-to-reach areas of the spine or for patients who may not be ideal candidates for traditional open surgery due to age or health concerns.
Indications for Endoscopic Removal of Spinal Tumors
Endoscopic removal of spinal tumors is typically considered for:
- Benign and malignant spinal tumors (e.g., schwannomas, meningiomas, ependymomas, metastases)
- Tumors in the epidural or intradural space
- Minimizing neurological complications in delicate spinal structures
- Patients requiring a less invasive option due to comorbidities
However, not all spinal tumors are suitable for this type of surgery. Tumors that are larger, more invasive, or located in particularly complex anatomical regions may require traditional open surgery. The decision to use endoscopic techniques depends on factors such as tumor size, location, and the patient's overall health.
Procedure for Endoscopic Removal of Spinal Tumors
In general, the procedure for endoscopic removal of spinal tumors may involve the following steps:
- The procedure is performed under general anesthesia to ensure the patient remains still and pain-free.
- The patient is positioned prone (face down) on the operating table for optimal spinal access.
- A small incision (usually less than 1 cm) is made near the affected spinal level.
- A dilator and working cannula are inserted to create a pathway, and a high-definition endoscope is introduced, providing a magnified, real-time view of the surgical area on a large television screen.
- If needed, a small portion of the bone (laminotomy or foraminotomy) is removed to access the tumor.
- Soft tissues, such as the dura or nerve roots, are carefully retracted to expose the tumor while minimizing nerve irritation.
- Specialized microsurgical instruments (such as forceps, lasers, or ultrasonic aspirators) are used to carefully dissect and remove the tumor.
- The tumor is extracted in small fragments or en bloc, depending on its consistency and location.
- The surgical site is irrigated and checked for complete tumor removal.
- The endoscope and working channel are removed, and the small incision is closed with sutures or adhesive strips.
Postoperative Care and Recovery
Postoperative care and recovery for endoscopic removal of spinal tumors typically involve a short hospital stay of 24–48 hours, with pain managed through oral medications. Patients are advised to avoid heavy lifting, bending, or twisting for several weeks, although light activities can often resume within days. Depending on the extent of the surgery and nerve involvement, physical therapy may be recommended to restore mobility and strength. Small incisions require minimal wound care, and follow-up appointments with imaging (MRI or CT scans) help monitor recovery and detect any recurrence. Most patients can return to sedentary work within 2–4 weeks, while full recovery may take 6–12 weeks, depending on the complexity of the procedure and individual healing.
Risks and Complications
While endoscopic removal of spinal tumors is a minimally invasive procedure with reduced risks compared to open surgery, potential complications still exist. These include:
- Nerve damage
- Incomplete tumor removal
- Spinal instability
- Cerebrospinal fluid (CSF) leak
- Infection and bleeding
- Tumor recurrence
Benefits
Advantages of endoscopic removal of spinal tumors over traditional open surgery include:
- Smaller incision and less scarring
- Reduced blood loss
- Lower risk of infection and complications
- Shorter hospital stay
- Faster return to daily activities
- Less postoperative pain
