Otsuki Kazuya, Hayashi Hideki, Hashikata Hirokuni, Toda Hiroki
Department of Neurosurgery, Medical Research Institute, Kitano Hospital, PIIF Tazuke-Kofukai, Osaka, Japan.
Department of Neurosurgery, Uji Tokushukai Hospital, Kyoto, Japan.
Eur Spine J. 2025 Aug 14. doi: 10.1007/s00586-025-09248-3.
Complete resection of spinal cord tumors in the thoracic region requires precise preservation of critical vascular structures such as the Adamkiewicz artery. This report highlights the utility of narrow band imaging (NBI) in achieving complete schwannoma removal, while preserving vascular integrity.
A 72-year-old male presented with left lower extremity weakness persisting for four months. He experienced difficulty cycling uphill and was forced to walk in a forward-bent posture. MRI revealed a dumbbell-shaped mass extending from the intradural space at Th12/L1 into the paravertebral region, resulting in the diagnosis of schwannoma arising from the left Th12 nerve root. Preoperative computed tomography angiography indicated proximity of the Adamkiewicz artery to the tumor. Intraoperatively, NBI facilitated identification and preservation of the Adamkiewicz artery during tumor removal. Postoperatively, the patient's muscle strength improved, and he resumed normal walking without forward bending posture.
NBI is a valuable adjunct for visualizing critical vascular structures intraoperatively, ensuring safe and effective tumor resection.
在胸段完整切除脊髓肿瘤需要精确保留关键血管结构，如Adamkiewicz动脉。本报告强调了窄带成像（NBI）在实现完整切除神经鞘瘤同时保留血管完整性方面的作用。
一名72岁男性，左下肢无力持续4个月。他在上坡骑车时遇到困难，被迫弯腰行走。MRI显示一个哑铃形肿块从胸12/腰1的硬膜内间隙延伸至椎旁区域，诊断为起源于左侧胸12神经根的神经鞘瘤。术前计算机断层血管造影显示Adamkiewicz动脉靠近肿瘤。术中，NBI有助于在切除肿瘤过程中识别和保留Adamkiewicz动脉。术后，患者肌肉力量改善，恢复正常行走，无需弯腰姿势。
NBI是术中可视化关键血管结构的有价值辅助手段，可确保安全有效地切除肿瘤。
