1. THE CASE OF TREATMENT OF THORACIC SPINAL NEURINOMA WITH TRANSTHORACIC EXTRAPLEURAL ACCESS: DESCRIPTION OF THE CLINICAL CASE AND LITERATURE ANALYSIS
- Author
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Anton V Yarikov, Dmitry P Evgrafov, Olga A Perlmutter, Alexander P Fraerman, Alexander E Simonov, Alexey K Istrelov, Alexey S Mukhin, Sergey N Tsybusov, Andrey G Sosnin, and Ivan V Gunkin
- Subjects
neurinoma ,hourglass tumor ,n-block resection ,transthoracic extrapleural access ,post-thoracotomy pain syndrome ,postoperative pain ,3d printing. ,Medicine (General) ,R5-920 - Abstract
Relevance. Spinal cord tumors account for 1,4-10,0 % of all tumors of the central nervous system. Among the tumors of the spinal cord, the incidence of tumors of the "hourglass" type (with intracanal/paravertebral) is 13-14 %. The incidence of neurinomas in the structure of primary extramedullary tumors reaches 40 % with the most frequent localization in the thoracic spine.Aim: to present a clinical case of surgical treatment of paravertebral neurinoma with transthoracic extrapleural access, to show its safety and advantage.Case descriptions. The paper describes a rare clinical case of surgical treatment of thoracic spine neurinoma. Before surgery, a puncture biopsy was performed under navigation using computed tomography. A total removal of the tumor from the transthoracic extrapleural access was performed. The technical nuances of the intervention are described and the operational possibilities of transthoracic extrapleural access in the removal of tumors of the posterior mediastinum of neurogenic origin are demonstrated. The experience of using transthoracic extrapleural access has shown its effectiveness in removing thoracic spine neurinomas. Further, the article provides a comparative analysis of various approaches for removing neurinomas of posterior mediastinal tumors of neurogenic origin. After 6 months, the patient underwent radiofrequency neuroablation of the intercostal nerve due to persistent post-thoracotomy pain syndrome.Conclusion. This clinical observation demonstrates the advantages of transthoracic extrapleural access, which can be successfully used in the removal of paravertebral neurinomas. Transthoracic extrapleural access shows advantages in terms of reducing intrapleural complications: pleurisy, atelectasis, pneumothorax, adhesive process in the pleural cavity.
- Published
- 2024
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