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

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

研究成果: Article

57 引用 (Scopus)

抄録

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.

元の言語English
ジャーナルSpine
29
発行部数1
出版物ステータスPublished - 2004 1 1
外部発表Yes

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Neoplasms
Three-Dimensional Imaging
Spine
Tomography
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

これを引用

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.

:: Spine, 巻 29, 番号 1, 01.01.2004.

研究成果: Article

Asazuma, T, Toyama, Y, Maruiwa, H, Fujimura, Y & Hirabayashi, K 2004, 'Surgical strategy for cervical dumbbell tumors based on a three-dimensional classification.', Spine, 巻. 29, 番号 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 1 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. :: Spine. 2004 ; 巻 29, 番号 1.
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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.",
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