Anterior to Dorsal Root Entry Zone Myelotomy (ADREZotomy): A New Surgical Strategy for the Therapy of Ventrolateral Deep Intramedullary Spinal Wire Cavernous Malformations.
Backbone (Phila Pa 1976). 2018 Feb 16;:
Authors: Ren J, He C, Hong T, Li X, Ma Y, Yu J, Ling F, Zhang H
STUDY DESIGN: A retrospective assessment of prospectively collected knowledge.
OBJECTIVE: To substantiate the feasibility of utilizing anterior to dorsal root entry zone myelotomy (ADREZotomy), a brand new surgical method, for the remedy of ventrolateral deep ISCCMs.
SUMMARY OF BACKGROUND DATA: Surgical elimination of ventrolateral deep intramedullary spinal twine cavernous malformations (ISCCMs) is very dangerous and stays problematic.
METHODS: The authors carried out a retrospective research exploring the surgical elimination of ventrolateral intrinsic ISCCMs utilizing ADREZotomy in 10 sufferers. The Frankel grading system was used to guage the sufferers’ neurological operate on the preoperative, postoperative and follow-up levels. American Spinal Harm Affiliation (ASIA) Scale scores on the preoperative and postoperative have been additionally obtained. The affected person traits and surgical outcomes have been analyzed. The indication, operative steps, issues, and anatomical foundation of the myelotomies have been described and mentioned.
RESULTS: In complete, 9 (90%) sufferers offered with gentle signs previous to surgical procedure. Gross complete resections have been carried out in all 10 sufferers. Instantly after surgical procedure, the neurological operate of eight (80.zero%) sufferers remained the identical. 1 affected person improved and 1 (10%) affected person worsened. There have been no different rapid or delayed issues associated to the surgical process. No lower of complete ASIA sensory scores was noticed. The follow-up neurological operate analysis confirmed that 2 (20%) sufferers improved from a Frankel grade of D to E and eight (80.zero%) sufferers have been secure. No recurrences or different extra neurological deterioration was noticed.
CONCLUSION: Surgical elimination of ventrolateral deep ISCCMs could be possible utilizing correct surgical strategies. ADREZotomy is a minimally invasive approach for the elimination of cervical and thoracic ventrolateral deep ISCCMs, with out disrupting the essential spinal twine tracts or the necessity to broadly expose bone.
LEVEL OF EVIDENCE: four.
PMID: 29462072 [PubMed – as supplied by publisher]