{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:34:24Z","timestamp":1781775264778,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Spinal dumbbell-shaped tumors are rare, usually benign tumors with intraspinal and paravertebral components connected through intervertebral foramen. Complete excision is often performed through traditional open surgery (TOS). The efficacy and long-term outcomes of minimally invasive surgery (MIS) have not been reported to date in resection of dumbbell-shaped spinal tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose was to evaluate the efficacy and long-term outcomes of minimally invasive resection combined with unilateral transforaminal intervertebral fusion (TIF) through comparing with TOS in the treatment of spinal dumbbell-shaped tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen patients underwent MIS and 18 patients underwent TOS. Thoracic dumbbell-shaped tumors were directly exposed after removal of costotransverse joints, adjacent rib components, unilateral hemilamina, and facet joints. Lumbar dumbbell-shaped tumors were completely exposed after removal of transverse processes, unilateral hemilamina, and facet joints. Whether for minimally invasive resection or traditional open removal, dumbbell-shaped tumors were completely excised and unilateral TIF was performed to guarantee spinal stability. All patients were followed up for 5 years at least.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean length of surgical incision for two groups was 3.47\u2009\u00b1\u20090.37 vs. 6.49\u2009\u00b1\u20090.39\u2005cm (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). The average duration of the operation was 131.67\u2009\u00b1\u200926.90 vs. 144.17\u2009\u00b1\u200923.59\u2005min (<jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090.05). The mean blood loss was 172.00\u2009\u00b1\u200948.79 vs. 285.83\u2009\u00b1\u200999.31\u2005ml (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). No blood transfusions were required in the two groups. The median length of hospitalization was 6 vs. 10 days (range: 5\u20138 vs. 7\u201314 days). The patients of two groups were monitored for an average of 65.93\u2009\u00b1\u20093.88 vs. 65.78\u2009\u00b1\u20093.56 months. At 5-year follow-up, all patients presented with normal neurological function (American Spinal Injury Association scale E). The Oswestry Disability Index in the MIS group decreased significantly more than the TOS group. No spondylolisthesis or spinal instability were found in the follow-up period. There was no recurrence of any spinal tumor 5 years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Spinal dumbbell-shaped tumors can be safely and effectively treated with minimally invasive resection combined with unilateral TIF. Compared with TOS, MIS offers a reduced length of surgical incision, blood loss, hospital stay, and postoperative pain. This surgical protocol might provide an alternative for the treatment of spinal dumbbell-shaped tumors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.939505","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T15:17:02Z","timestamp":1663859822000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["One step excision combined with unilateral transforaminal intervertebral fusion via minimally invasive technique in the surgical treatment of spinal dumbbell-shaped tumors: A\u00a0retrospective study with a minimum of 5 years\u2019 follow-up"],"prefix":"10.3389","volume":"9","author":[{"given":"Jianfeng","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutong","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1227\/01.NEU.0000153752.59565.BB","article-title":"Clinical characteristics of spinal nerve sheath tumors: analysis of 149 cases","volume":"56","author":"Jinnai","year":"2005","journal-title":"Neurosurgery"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/spi.2005.3.1.0001","article-title":"Extrathecal intraradicular nerve sheath tumor","volume":"3","author":"Celli","year":"2005","journal-title":"J Neurosurg Spine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1097\/SAP.0000000000001831","article-title":"The value of plastic surgery spinal closures a review of 782 spine cases","volume":"83","author":"Xu","year":"2019","journal-title":"Ann Plast Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.1097\/00006123-200211002-00006","article-title":"Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience","volume":"51","author":"Fessler","year":"2002","journal-title":"Neurosurgery"},{"key":"B5","doi-asserted-by":"publisher","first-page":"S146","DOI":"10.1097\/00006123-200211002-00020","article-title":"Microendoscopic decompressive laminotomy for the treatment of lumbar stenosis","volume":"51","author":"Khoo","year":"2002","journal-title":"Neurosurgery"},{"key":"B6","doi-asserted-by":"publisher","first-page":"694","DOI":"10.3171\/2009.12.SPINE09621","article-title":"An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion","volume":"12","author":"Wang","year":"2010","journal-title":"J Neurosurg Spine"},{"key":"B7","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/BRS.0b013e318191438b","article-title":"A biomechanical evaluation of graded posterior element removal for treatment of lumbar stenosis comparison of a minimally invasive approach with two standard laminectomy techniques","volume":"34","author":"Bresnahan","year":"2009","journal-title":"Spine"},{"key":"B8","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.clinbiomech.2008.11.005","article-title":"Biomechanical comparison of traditional and minimally invasive intradural tumor exposures using finite element analysis","volume":"24","author":"Ogden","year":"2009","journal-title":"Clin Biomech"},{"key":"B9","doi-asserted-by":"publisher","first-page":"E11","DOI":"10.3171\/2015.5.FOCUS15129","article-title":"Comparison of open and minimally invasive surgery for intradural-extramedullary spine tumors","volume":"39","author":"Wong","year":"2015","journal-title":"Neurosurg Focus"},{"key":"B10","doi-asserted-by":"publisher","first-page":"4108","DOI":"10.1007\/s00586-016-4677-z","article-title":"Minimally invasive resection of extradural dumbbell tumors of thoracic spine: surgical techniques and literature review","volume":"25","author":"Li","year":"2016","journal-title":"Eur Spine J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"708","DOI":"10.3171\/2013.9.SPINE121061","article-title":"Minimally invasive removal of thoracic and lumbar spinal tumors using a nonexpandable tubular retractor","volume":"19","author":"Nzokou","year":"2013","journal-title":"J Neurosurg Spine"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-016-0823-7","article-title":"Thoracolumbar paravertebral giant ganglioneuroma and scoliosis: a case report and literature review","volume":"14","author":"Yang","year":"2016","journal-title":"World J Surg Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1097\/00007632-199506020-00014","article-title":"Anterior fresh frozen structural allografts in the thoracic and lumbar spine. 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