Ponce-Gómez Juan Antonio, Tejada-Pineda María Fernanda, Muñuzuri-Camacho Marco, Moreno-Jiménez Sergio, Romano-Feinholz Samuel, Alcocer-Barradas Victor, Osuna-Zazueta Marcela Amparo, Zárate-García José Pablo, Moscardini-Martelli Júlia, Ortega-Porcayo Luis Alberto
Centro Médico ABC, Mexico City, Mexico.
Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, Mexico.
Int J Spine Surg. 2025 Jun 12;19(3):324-329. doi: 10.14444/8733.
Intramuscular myxomas (IMs) are rare benign neoplasms of fibroblastic origin, typically presenting in adults, with a female predominance. IMs are uncommonly located in the skeletal muscles, most frequently in the thighs, but rarely in the paraspinal region. IM may be located deeply in this region and that could present a challenge for complete resection.
A 66-year-old woman presented with progressive lower back pain and radicular symptoms, which were due to a paraspinal IM.
The patient underwent a minimally invasive microsurgical resection assisted by a 45° endoscopic microinspection tool (QEVO) to enhance visualization and access the lateral compartment of the tumor. Microsurgical dissection assisted with endoscopic visualization allowed successful resection of the tumor, including its lateral compartment, without extensive muscle transection. No complications occurred during or after surgery, and the patient reported complete symptom relief with no recurrence after 2 years.
This case demonstrates the value of integrating endoscopic tools in spinal surgery, particularly in cases where conventional microsurgical techniques are insufficient for complete tumor resection using less invasive approaches. The enhanced visualization provided by the 45° endoscope facilitated the successful resection of a paraspinal lesion, improving surgical precision and patient outcomes.
The QEVO microinspection tool is an effective adjunct to microsurgical techniques, offering enhanced visualization and precision during tumor resection. This case highlights its potential to address the challenges posed by deeply located paralumbar tumors. As further research explores its use in spine surgery, this microinspection tool could become an important asset in minimally invasive spinal tumor resections, improving patient outcomes through better tissue preservation and complete resection.
肌内黏液瘤（IMs）是一种罕见的成纤维细胞源性良性肿瘤，多见于成年人，女性居多。IMs很少位于骨骼肌，最常见于大腿，但很少见于脊柱旁区域。IM在该区域可能位置较深，这可能给完整切除带来挑战。
一名66岁女性因脊柱旁IM出现进行性下背部疼痛和神经根症状。
患者在45°内镜显微检查工具（QEVO）辅助下接受了微创显微手术切除，以增强可视化并进入肿瘤外侧腔隙。在内镜可视化辅助下的显微手术解剖成功切除了肿瘤，包括其外侧腔隙，且未进行广泛的肌肉横断。手术期间及术后均未发生并发症，患者报告症状完全缓解，2年后无复发。
本病例展示了在内镜工具在脊柱手术中的价值，特别是在传统显微手术技术不足以采用侵入性较小的方法完整切除肿瘤的情况下。45°内镜提供的增强可视化有助于成功切除脊柱旁病变，提高了手术精度和患者预后。
QEVO显微检查工具是显微手术技术的有效辅助手段，在肿瘤切除过程中提供了增强的可视化和精度。本病例突出了其应对腰旁深部肿瘤所带来挑战的潜力。随着进一步研究探索其在脊柱手术中的应用，这种显微检查工具可能成为微创脊柱肿瘤切除的重要资产，通过更好地保留组织和完整切除来改善患者预后。
