Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification.

Takashi Asazuma, Yoshiaki Toyama, Hirofumi Maruiwa, Yoshikazu Fujimura, Kiyoshi Hirabayashi

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

STUDY DESIGN: Forty-two patients with cervical dumbbell tumors were analyzed retrospectively using a new three-dimensional classification. OBJECTIVES: To establish optimal surgical strategies, we considered shapes and three-dimensional locations of cervical dumbbell tumors based on diagnostic images and intraoperative findings. SUMMARY OF BACKGROUND DATA: Eden's classification for dumbbell tumors of the spine, long considered a "gold standard," no longer is sufficient to determine surgical strategy in view of recent advances in computed tomography and magnetic resonance imaging. METHODS: Forty-two cervical dumbbell tumors were characterized according to transverse-section images (Toyama classification; nine types) and craniocaudal extent of intervertebral and transverse foraminal involvement (IF and TF staging; three stages each). RESULTS: Type IIIa tumors, involving dura plus an intervertebral foramen, accounted for 50% of cases. A posterior approach was used in 35 patients; 7 others underwent a combined anterior and posterior approach. A posterior approach was used for all type IIa and IIIa tumors, and for some type IIIb (upper cervical), IV, and VI tumors; a combined posterior and anterior approach was used for type IIb and the remainder of type IV and VI. Reconstruction was performed using spinal instrumentation in 4 patients (9.5%). Resection was subtotal in 6 patients (14.3%) and total in 36 (85.7%). CONCLUSIONS: Systematic, imaging-based three-dimensional characterization of shape and location of cervical dumbbell tumors is essential for planning optimal surgery. The classification used here fulfills this need.

Original languageEnglish
JournalSpine
Volume29
Issue number1
Publication statusPublished - 2004 Jan 1
Externally publishedYes

Fingerprint

Neoplasms
Three-Dimensional Imaging
Spine
Tomography
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Asazuma, T., Toyama, Y., Maruiwa, H., Fujimura, Y., & Hirabayashi, K. (2004). Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification. Spine, 29(1).

Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification. / Asazuma, Takashi; Toyama, Yoshiaki; Maruiwa, Hirofumi; Fujimura, Yoshikazu; Hirabayashi, Kiyoshi.

In: Spine, Vol. 29, No. 1, 01.01.2004.

Research output: Contribution to journalArticle

Asazuma, T, Toyama, Y, Maruiwa, H, Fujimura, Y & Hirabayashi, K 2004, 'Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification.', Spine, vol. 29, no. 1.
Asazuma T, Toyama Y, Maruiwa H, Fujimura Y, Hirabayashi K. Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification. Spine. 2004 Jan 1;29(1).
Asazuma, Takashi ; Toyama, Yoshiaki ; Maruiwa, Hirofumi ; Fujimura, Yoshikazu ; Hirabayashi, Kiyoshi. / Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification. In: Spine. 2004 ; Vol. 29, No. 1.
@article{edf24cba667d429ab9c681f6925ac841,
title = "Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification.",
abstract = "STUDY DESIGN: Forty-two patients with cervical dumbbell tumors were analyzed retrospectively using a new three-dimensional classification. OBJECTIVES: To establish optimal surgical strategies, we considered shapes and three-dimensional locations of cervical dumbbell tumors based on diagnostic images and intraoperative findings. SUMMARY OF BACKGROUND DATA: Eden's classification for dumbbell tumors of the spine, long considered a {"}gold standard,{"} no longer is sufficient to determine surgical strategy in view of recent advances in computed tomography and magnetic resonance imaging. METHODS: Forty-two cervical dumbbell tumors were characterized according to transverse-section images (Toyama classification; nine types) and craniocaudal extent of intervertebral and transverse foraminal involvement (IF and TF staging; three stages each). RESULTS: Type IIIa tumors, involving dura plus an intervertebral foramen, accounted for 50{\%} of cases. A posterior approach was used in 35 patients; 7 others underwent a combined anterior and posterior approach. A posterior approach was used for all type IIa and IIIa tumors, and for some type IIIb (upper cervical), IV, and VI tumors; a combined posterior and anterior approach was used for type IIb and the remainder of type IV and VI. Reconstruction was performed using spinal instrumentation in 4 patients (9.5{\%}). Resection was subtotal in 6 patients (14.3{\%}) and total in 36 (85.7{\%}). CONCLUSIONS: Systematic, imaging-based three-dimensional characterization of shape and location of cervical dumbbell tumors is essential for planning optimal surgery. The classification used here fulfills this need.",
author = "Takashi Asazuma and Yoshiaki Toyama and Hirofumi Maruiwa and Yoshikazu Fujimura and Kiyoshi Hirabayashi",
year = "2004",
month = "1",
day = "1",
language = "English",
volume = "29",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification.

AU - Asazuma, Takashi

AU - Toyama, Yoshiaki

AU - Maruiwa, Hirofumi

AU - Fujimura, Yoshikazu

AU - Hirabayashi, Kiyoshi

PY - 2004/1/1

Y1 - 2004/1/1

N2 - STUDY DESIGN: Forty-two patients with cervical dumbbell tumors were analyzed retrospectively using a new three-dimensional classification. OBJECTIVES: To establish optimal surgical strategies, we considered shapes and three-dimensional locations of cervical dumbbell tumors based on diagnostic images and intraoperative findings. SUMMARY OF BACKGROUND DATA: Eden's classification for dumbbell tumors of the spine, long considered a "gold standard," no longer is sufficient to determine surgical strategy in view of recent advances in computed tomography and magnetic resonance imaging. METHODS: Forty-two cervical dumbbell tumors were characterized according to transverse-section images (Toyama classification; nine types) and craniocaudal extent of intervertebral and transverse foraminal involvement (IF and TF staging; three stages each). RESULTS: Type IIIa tumors, involving dura plus an intervertebral foramen, accounted for 50% of cases. A posterior approach was used in 35 patients; 7 others underwent a combined anterior and posterior approach. A posterior approach was used for all type IIa and IIIa tumors, and for some type IIIb (upper cervical), IV, and VI tumors; a combined posterior and anterior approach was used for type IIb and the remainder of type IV and VI. Reconstruction was performed using spinal instrumentation in 4 patients (9.5%). Resection was subtotal in 6 patients (14.3%) and total in 36 (85.7%). CONCLUSIONS: Systematic, imaging-based three-dimensional characterization of shape and location of cervical dumbbell tumors is essential for planning optimal surgery. The classification used here fulfills this need.

AB - STUDY DESIGN: Forty-two patients with cervical dumbbell tumors were analyzed retrospectively using a new three-dimensional classification. OBJECTIVES: To establish optimal surgical strategies, we considered shapes and three-dimensional locations of cervical dumbbell tumors based on diagnostic images and intraoperative findings. SUMMARY OF BACKGROUND DATA: Eden's classification for dumbbell tumors of the spine, long considered a "gold standard," no longer is sufficient to determine surgical strategy in view of recent advances in computed tomography and magnetic resonance imaging. METHODS: Forty-two cervical dumbbell tumors were characterized according to transverse-section images (Toyama classification; nine types) and craniocaudal extent of intervertebral and transverse foraminal involvement (IF and TF staging; three stages each). RESULTS: Type IIIa tumors, involving dura plus an intervertebral foramen, accounted for 50% of cases. A posterior approach was used in 35 patients; 7 others underwent a combined anterior and posterior approach. A posterior approach was used for all type IIa and IIIa tumors, and for some type IIIb (upper cervical), IV, and VI tumors; a combined posterior and anterior approach was used for type IIb and the remainder of type IV and VI. Reconstruction was performed using spinal instrumentation in 4 patients (9.5%). Resection was subtotal in 6 patients (14.3%) and total in 36 (85.7%). CONCLUSIONS: Systematic, imaging-based three-dimensional characterization of shape and location of cervical dumbbell tumors is essential for planning optimal surgery. The classification used here fulfills this need.

UR - http://www.scopus.com/inward/record.url?scp=2142688697&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2142688697&partnerID=8YFLogxK

M3 - Article

VL - 29

JO - Spine

JF - Spine

SN - 0362-2436

IS - 1

ER -