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The use of spinal angiography in the management of posterior mediastinal tumors: Case series and review of the literature
- Source :
- Journal of Pediatric Surgery. 48:1871-1877
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Introduction Resection of inferiorly located posterior mediastinal tumors can be complicated by their proximity to the artery of Adamkiewicz (AKA). Although uncommon, intraoperative injury to the AKA may result in paraparesis or paralysis secondary to spinal cord ischemia. The use of preoperative spinal angiography may serve as a useful adjunct to the surgeon in guiding extent of resection of the tumor to avoid injury to this critical artery. Methods After IRB approval (H-31712), three patients, from 2008 to 2011, with lower posterior mediastinal tumors were identified. Their charts were reviewed for information concerning preoperative imaging, operative details, and postoperative neurologic complications. The literature regarding imaging of the AKA, cases of injury in pediatric patients, and recommendations for treatment after its injury were reviewed. Results One patient, who did not have preoperative spinal angiography, developed transient paresis lasting 6weeks after posterior mediastinal tumor resection. Two patients underwent preoperative spinal angiography with successful localization of the AKA. In both cases, the patients subsequently underwent posterior mediastinal tumor resection without injury to the artery and without postoperative neurologic sequelae. Conclusions Preoperative spinal angiography may serve as a useful adjunct in the evaluation of children with inferior posterior mediastinal tumors in order to delineate the relationship of the artery of Adamkiewicz to the tumor for the purpose of guiding surgical resection.
- Subjects :
- medicine.medical_specialty
Intraoperative Neurophysiological Monitoring
medicine.medical_treatment
Mediastinal tumor
Mediastinal Neoplasms
Thoracic Vertebrae
Postoperative Complications
Paraparesis
Ischemia
medicine.artery
Preoperative Care
Paralysis
Humans
Medicine
Thoracotomy
Intraoperative Complications
medicine.diagnostic_test
business.industry
Angiography
Ganglioneuroma
Magnetic resonance imaging
Arteries
General Medicine
medicine.disease
Magnetic Resonance Imaging
Surgery
Pleural Effusion
medicine.anatomical_structure
Intraoperative Injury
Spinal Cord
Child, Preschool
Pediatrics, Perinatology and Child Health
Thoracic vertebrae
Female
Dura Mater
Radiology
Artery of Adamkiewicz
medicine.symptom
business
Spinal Cord Compression
Lipoblastoma
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....99ec9a6942aadeb68e6fe1f0ed5d4d8d