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CC BY 4.0 · Surg J (N Y) 2016; 02(03): e66-e69
DOI: 10.1055/s-0036-1587692
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Minimally Invasive Direct Lateral Transpsoas Approach for the Resection of a Lumbar Plexus Schwannoma: Technique Report

Carolina G. Benjamin
1   Georgetown Medical School, Washington, District of Columbia
,
Eric K. Oermann
1   Georgetown Medical School, Washington, District of Columbia
,
J. Alexander Thomas
2   Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, District of Columbia
,
Casey T. Distaso
1   Georgetown Medical School, Washington, District of Columbia
,
Faheem A. Sandhu
2   Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, District of Columbia
› Author Affiliations
Further Information

Publication History

12 April 2016

11 July 2016

Publication Date:
06 August 2016 (online)

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Abstract

Objective Traditional techniques for resection of lumbar plexus tumors have been associated with approach-related morbidity. We describe a case utilizing a minimally invasive transpsoas lateral access approach to resect a retroperitoneal tumor of the lumbar plexus.

Methods We report a case with an extradural retroperitoneal schwannoma of the L4 nerve root that was treated with a minimally invasive direct lateral transpsoas approach using atraumatic tissue dilators and an expandable tubular retractor. The use of directional and continuous electromyographic monitoring was critical in locating the plexus and positioning the retractor immediately anterior to the tumor.

Results The patient tolerated the procedure well without postoperative complications. The operative approach was direct and intraoperative blood loss was negligible. The patient demonstrated improved left leg strength and ambulation and resolution of paresthesias.

Conclusions A minimally invasive direct lateral transpsoas access approach is an effective technique to safely and adequately resect extradural retroperitoneal lumbar plexus tumors.

Keywords

lateral - retroperitoneal - transpsoas - minimally invasive - lumbar plexus tumors - schwannoma
 

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