Analysis of the efficacy of microscopic surgery for neurinoma in the thoracolumbar intervertebral foraminal region via the Wiltse approach
Ding Daling
Qiu Kai
Zhang Fengjiang
Yu Bin
Chen Yu
Li En
Pang Changhe
Abstract：Objective To compare the surgical outcomes of the Wiltse approach and the traditional posterior median approach for the treatment of neurinomas in the thoracolumbar intervertebral foramen region. Methods The clinical data of 57 patients with neurinoma in the thoracolumbar intervertebral foramen region were analyzed retrospectively. The patients were divided into the Wiltse approach group (n=32) and the posterior median approach group (n=25) based on the surgical method. There were no significant differences between the two groups in terms of gender,age and tumor location (all P>0.05). The surgical duration,intraoperative blood loss,surgical incision length,postoperative hospital stay and postoperative complications were compared between the two groups. The preoperative pain level and postoperative pain relief were assessed using the Visual Analogue Scale (VAS),and the recovery status of symptoms in both groups was observed. Results All surgeries were successfully completed,and the pathological results were neurinomas. The Wiltse approach group had significantly shorter surgical duration,less intraoperative blood loss,and shorter postoperative hospital stay compared with the posterior median approach group,with statistically significant differences (all P<0.05). Compared with preoperative levels,the VAS scores in the Wiltse approach group improved significantly at both 1 month and 3 months postoperatively (both P<0.05). The VAS scores at 3 months postoperatively were significantly lower in the Wiltse approach group than in the posterior median approach group,with a statistically significant difference (P=0.029). Regular follow-up MRI examinations showed no recurrence of the tumor. Conclusions Compared with the traditional posterior median approach,the Wiltse approach offers advantages such as shorter surgical duration,less intraoperative blood loss,faster postoperative recovery,shorter hospital stay,and better preservation of the articular process joints and ligamentous complex. The Wiltse approach for the treatment of neurinomas in the thoracolumbar intervertebral foramen region demonstrates good clinical efficacy and significant surgical advantages.
Keywords：neurinomaintervertebral foraminal areadumbbell-shaped tumorWiltse approach
Publication Date：2024-11-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 641-646 )