Transthoracic Extrapleural Approach in the Treatment of Thoracic Spinal Neurinoma: Description of the Clinical Case and Literature Analysis

Background. Spinal tumors account for 1.4–10.0 % of all central nervous system tumors. Among spinal tumors, the incidence of hourglass tumors (with intracanal/paravertebral location) is 13–14 %. The incidence of neurilemmomas in the structure of primary extramedullary tumors reaches 40 %, and the most common location is thoracic spine. The aim of the work. To present a clinical case of surgical treatment of paravertebral neurilemmoma using transtho-racic extrapleural approach, to show its safety and advantage. Clinical case. The article describes a rare clinical case of surgical treatment of neurilemmoma of the thoracic spine. Before surgery, a puncture biopsy was performed using computed tomography navigation. Total tumor resection was performed through a transthoracic extrapleural approach. The article describes the technical nuances of the sur-gery and demonstrates the surgical capabilities of transthoracic extrapleural approach for resection of the posterior mediastinum tumors of neurogenic origin. Using transthoracic extrapleural approach has shown its effectiveness in thoracic spine neurilemmoma resection. A comparative analysis of various approaches for the resection of posterior mediastinum neurilemmomas of neurogenic origin was carried out. After 6 months, the patient underwent radiofre-quency neuroablation of the intercostal nerve due to persistent post-thoracotomy pain syndrome. Conclusion. This clinical observation demonstrates the advantages of transthoracic extrapleural approach, which allow their successful use in the paravertebral neurilemmomas resection. Transthoracic extrapleural approach shows advan-tages in reducing intrapleural complications: pleurisy, atelectasis, pneumothorax, pleural cavity adhesions.