Surgical Strategies in the Management of XXXX .

@entity1 @entity808 @entity5 @entity204 @entity4847
OBJECTIVES: @entity4847 ( @entity4847 ) are the most common lesions in the extramedullary intradural compartment. Complex and large lesions may pose technical difficulties for the operating surgeons. We discuss the management of @entity4847 and technical issues including surgical approaches, spinal fixation, and dural handling with the goal of achieving good clinical outcomes while minimizing the risk of complications. We also propose a new classification for @entity4847 to guide surgical treatment of these @entity5 . METHODS: A retrospective analysis was performed of 61 @entity1 who underwent surgery for @entity4847 during the period 1995-2012. The posterior approach was used for removal of most @entity5 (n  = 53). Lesions having a substantial extraforaminal component were accessed from the anterior or lateral approach or a combined approach. Concomitant spinal fixation and fusion was performed in 7 @entity1 . RESULTS: Most of the @entity1 (n  = 53) had clinical improvement; clinical status was the same in 4 @entity1 and worse in the remaining 4 @entity1 . One or more complications developed in 18 @entity1 (29.5%). Recurrence was the most common complication (n  = 7). @entity204 occurred in 2 @entity1 with @entity808 12 and 8 months, respectively, after surgical resection. CONCLUSIONS: Lesions with large extraforaminal extension pose technical difficulty. Spinal fixation with fusion should be supplemented whenever necessary. Complications related to dura mater may be associated with significant morbidity, and all possible efforts should be made to prevent them.
