{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T09:56:06Z","timestamp":1774605366454,"version":"3.50.1"},"reference-count":39,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Thoracic spinal schwannomas are benign nervesheath tumors that can cause significant neurological impairment. Surgical resection remains the treatment of choice and gold standard for achieving gross total resection and preventing recurrence. The lateral extracavitary approach (LECA) and lateral thoracotomy (LT) are commonly used techniques; however, the relative advantages of these two approaches remain uncertain, and comparative data in the Mexican population are lacking.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n We performed a retrospective cohort study of adults undergoing LECA or LT for thoracic spinal schwannoma at the National Cancer Institute of Mexico (2011\u20132018). Patients were selected according to tumor location, extension, cardiopulmonary tolerance, and surgeon experience, as detailed in the study methods. Demographic, radiological, and perioperative data were collected. Outcomes included tumor size\/volume, operative time, estimated blood loss (EBL), length of stay (LOS), pain (Visual Analog Scale, VAS), neurological outcome (American Spinal Injury Association grade), and complications. Statistical significance was set at\n P<\/jats:italic>\n < 0.05. Given the observed differences in tumor volume between groups, a dedicated statistical comparison was performed using the Mann\u2013Whitney U test. In addition, a stratified analysis by tumor size (\u226450 cm\n 3<\/jats:sup>\n vs. >50 cm\n 3<\/jats:sup>\n ) was conducted to evaluate whether differences between surgical approaches persisted within each stratum.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Forty-three patients were included (LECA\n n<\/jats:italic>\n = 23; LT\n n<\/jats:italic>\n = 20). Median EBL was lower with LECA (180 mL) versus LT (600 mL;\n P<\/jats:italic>\n = 0.019). LECA had shorter operative time (median 3 h vs. 5 h;\n P<\/jats:italic>\n < 0.001) and hospital stay (4 vs. 11 days;\n P<\/jats:italic>\n = 0.004). Pain improved significantly after LECA (VAS 8\u21922;\n P<\/jats:italic>\n < 0.001) but not after LT (9\u21927;\n P<\/jats:italic>\n = 0.70). Tumor volume was significantly larger in the LT group (\n P<\/jats:italic>\n < 0.0001), representing a potential confounder; however, the advantages of LECA persisted in the stratified analysis (\u226450 cm\n 3<\/jats:sup>\n and >50 cm\n 3<\/jats:sup>\n ). Complications occurred in 10% (LECA) versus 25% (LT), not statistically significant given the small cohort. No perioperative mortality occurred.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n In this single-center retrospective cohort, LECA was associated with reduced operative time, blood loss, LOS, and postoperative pain compared with LT. The potential benefits of LECA likely reflect improved exposure and reduced pleural morbidity inherent to the approach, though confounding by tumor size and patient selection cannot be excluded. Given the retrospective design and limited statistical power, findings should be interpreted cautiously and validated in prospective multicenter studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_963_2025","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T09:11:40Z","timestamp":1774602700000},"page":"183","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the lateral extracavitary and lateral thoracotomy surgical approaches for the treatment of thoracic spinal schwannomas"],"prefix":"10.25259","volume":"17","author":[{"given":"Gervith","family":"Reyes Soto","sequence":"first","affiliation":[{"name":"Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerolog\u00eda, San Fernando, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Castillo-Rangel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica","family":"Serrano-Murillo","sequence":"additional","affiliation":[{"name":"Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerolog\u00eda, San Fernando, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Alejandro","family":"Vega-Moreno","sequence":"additional","affiliation":[{"name":"Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerolog\u00eda, San Fernando, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bosco Emanuel","family":"Lazo Poveda","sequence":"additional","affiliation":[{"name":"Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerolog\u00eda, San Fernando, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey Misael","family":"Aguilar Mora","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Ju\u00e1rez de M\u00e9xico, Mexico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel de Jes\u00fas","family":"Encarnaci\u00f3n-Ramirez","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Histology, Institute of Clinical Medicine Named After N.V. Sklifosovskiy, Moscow, Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Garc\u00eda Aquino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Regional ISSSTE, Puebla, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Joaquin","family":"Robles Ortiz","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Instituto Nacional de Rehabilitaci\u00f3n LGII, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mois\u00e9s Jacob","family":"L\u00f3pez-Ju\u00e1rez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario \u201cDr Jos\u00e9 Eleuterio Gonz\u00e1lez,\u201d Nuevo Le\u00f3n, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Humberto","family":"Ayala-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 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