Surgical TechniqueComplete Excision of Intradural-Extraforaminal Spinal Tumors Using a Minimally Invasive 2-Incision Technique With Fixed Tubular RetractorsSrikantha, Umesh MCh; Hari, Akshay DNB; Lokanath, Yadhu K. MCh; Subramanian, Nirmala MCh; Varma, Ravi Gopal MChAuthor Information Department of Neurosurgery, Aster CMI Hospital, Bengaluru, Karnataka, India The authors declare no conflict of interest. Reprints: Akshay Hari, DNB, Department of Neurosurgery, Aster CMI Hospital, 43/2, New Airport Road, NH.7, Hebbal, Sahakara Nagar, Bengaluru 560092, Karnataka, India (e-mail: [email protected]). Clinical Spine Surgery: April 2021 - Volume 34 - Issue 3 - p 92-102 doi: 10.1097/BSD.0000000000001036 Buy SDC Metrics Abstract Spinal tumors are rare, of which intradural-extramedullary lesions form the majority of primary spinal tumors. Occasionally these may even be large, dumbbell shaped, with both intraspinal and extraspinal components. Complete gross total resection is the gold standard in the removal of these tumors since most are benign in nature. Traditionally this has been achieved using large open midline approaches that involve significant muscle dissection, extensive laminectomy, and even facetectomy. This may lead to instability, requiring stabilization to prevent deformity. Minimally invasive surgical approaches using fixed tubular retractors may obviate this need by minimizing the amount of muscle stripping and bony resection required for complete tumor excision. By utilizing facet sparing corridors, the authors describe a novel 2-incision minimally invasive surgical technique that combines a paramedian and a far-lateral approach to access both the intraspinal and extraforaminal, paraspinal portions of the tumor for achieving complete excision. Three illustrative cases are discussed with tumors in 2 different spinal locations that highlights the versatility of this technique—1 in the cervical region and the other 2 in the thoracolumbar region. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.