Challenges with Spinal Tumor (Intradural Extramedullary) Excision by Full-Endoscopic Mono-Portal Technique

There has been a tremendous focus on endoscopic spine surgery in the past two decades. The aims and objectives of this study are to evaluate the safety and effectiveness of full-endoscopic mono-portal excision of spinal tumors, that is, intradural extramedullary (IDEM). We included five cases (n = 5) from different age groups in this study. IDEM tumors were at different levels, including the D12–L1 junctional area. All underwent excision through the full-endoscopic mono-portal approach. Few instruments were customized (endo-dural knife, knot-pusher), and tumors were mobilized, separated, and excised. Endo-suturing was performed with Prolene 6–0 1/2 circle sutures. All the patients were observed for wound leak, motor or sensory deficit, and functional outcomes in the postoperative period. All had no/no added deficit postoperatively, and Visual Analog Scale (VAS)/American Spine Injury Association (ASIA) scores improved in the postoperative period. There was no cerebrospinal fluid (CSF) leak or pseudomeningocele formation during hospital stay or in follow-ups. The full-endoscopic mono-portal excision of IDEM spine tumors appears to be a feasible technique, with the advantages of a small skin incision, less tissue damage, and early ambulation.