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Combined Video-Assisted Thoracic Surgery and Posterior Spinal Surgery for the Treatment of Dumbbell Tumor of the First Thoracic Nerve Root.

Ohya J, Miyoshi K, Kitagawa T, Sato Y, Maehara T, Mikami Y - Asian Spine J (2015)

Bottom Line: Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root.We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position.The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan. ; Department of Orthopaedic Surgery, Yokohama Rosai Hospital, Yokohama, Japan.

ABSTRACT
Although several cases of a dumbbell tumor of thoracic nerve roots have been reported, reports on the surgical procedures for a dumbbell tumor of the first thoracic (T1) nerve root are rare. Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root. We present cases with dumbbell tumors of the T1 nerve root that were treated with combined surgical treatment to remove the tumor. We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position. The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.

No MeSH data available.


Related in: MedlinePlus

(A) The tumor during video-assisted thoracic surgery. (B) The tumor after anterior release of the ambient organs.
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Figure 4: (A) The tumor during video-assisted thoracic surgery. (B) The tumor after anterior release of the ambient organs.

Mentions: A combination of VATS and posterior spinal surgery was performed to remove the tumor. Anterior release using VATS in the left lateral position was performed initially (Fig. 4). During the posterior spinal surgery following VATS, a response to intraoperative nerve stimulation on the T1 nerve root distal to the tumor was confirmed. Therefore, enucleation of the tumor was performed using an operating microscope to preserve intrinsic muscle function (Fig. 5). The patient had motor deficits in the flexor digitorum profundus muscle and intrinsic muscle of her right hand after surgery (grades 3 and 5, respectively), which improved slightly during the follow-up period (grades 4 and 5, respectively). Imaging showed no recurrence at the latest follow-up.


Combined Video-Assisted Thoracic Surgery and Posterior Spinal Surgery for the Treatment of Dumbbell Tumor of the First Thoracic Nerve Root.

Ohya J, Miyoshi K, Kitagawa T, Sato Y, Maehara T, Mikami Y - Asian Spine J (2015)

(A) The tumor during video-assisted thoracic surgery. (B) The tumor after anterior release of the ambient organs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522451&req=5

Figure 4: (A) The tumor during video-assisted thoracic surgery. (B) The tumor after anterior release of the ambient organs.
Mentions: A combination of VATS and posterior spinal surgery was performed to remove the tumor. Anterior release using VATS in the left lateral position was performed initially (Fig. 4). During the posterior spinal surgery following VATS, a response to intraoperative nerve stimulation on the T1 nerve root distal to the tumor was confirmed. Therefore, enucleation of the tumor was performed using an operating microscope to preserve intrinsic muscle function (Fig. 5). The patient had motor deficits in the flexor digitorum profundus muscle and intrinsic muscle of her right hand after surgery (grades 3 and 5, respectively), which improved slightly during the follow-up period (grades 4 and 5, respectively). Imaging showed no recurrence at the latest follow-up.

Bottom Line: Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root.We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position.The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan. ; Department of Orthopaedic Surgery, Yokohama Rosai Hospital, Yokohama, Japan.

ABSTRACT
Although several cases of a dumbbell tumor of thoracic nerve roots have been reported, reports on the surgical procedures for a dumbbell tumor of the first thoracic (T1) nerve root are rare. Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root. We present cases with dumbbell tumors of the T1 nerve root that were treated with combined surgical treatment to remove the tumor. We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position. The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.

No MeSH data available.


Related in: MedlinePlus