Functional outcome and surgical efficacy of minimally invasive tubular retractor system in spinal tumor excision: A prospective cross-sectional study from a tertiary care centre.

Rahul Deo; Anirudha Doshi; Prathamesh Pathrikar; Sumitkumar Pundlik Bhagat

doi:10.51168/gd48bz59

Authors

Dr.Rahul Deo Senior Resident, Department of Neurosurgery, IGIMS, Patna, Bihar, India
Dr. Anirudha Doshi Associate Consultant, Department of Neurosurgery, Kokilaben dhirubhai ambani hospital and research centre, India
Dr. Prathamesh Pathrikar 3rd Year DrNB Resident, Department of Neurosurgery, Kokilaben Dhirubhai ambani hospital and medical research centre, India
Dr. Sumitkumar Pundlik Bhagat DrNB Resident, Department of Neurosurgery, Kokilaben Dhirubhai ambani hospital and medical research centre, India

DOI:

https://doi.org/10.51168/gd48bz59

Keywords:

Minimally invasive spinal surgery, tubular retractor system, spinal tumors, functional outcome, surgical efficacy

Abstract

Background:

Minimally invasive spinal surgery using tubular retractor systems has gained increasing acceptance in spinal oncology because of reduced tissue trauma, decreased blood loss, and faster postoperative recovery. However, prospective evidence on its functional outcomes and surgical efficacy remains limited.

Aim:

To evaluate the functional outcome and surgical efficacy of minimally invasive tubular retractor systems in spinal tumor excision.

Methods:

This prospective observational study was conducted at Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, over two years. Sixty adult patients (mean age: 48.2 ± 11.4 years; 35 males and 25 females) undergoing minimally invasive spinal tumor excision using tubular retractor systems were enrolled. Functional outcomes were assessed using the Modified McCormick Scale (MMS) and Visual Analog Scale (VAS). Operative duration, blood loss, extent of tumor excision, hospital stay, postoperative complications, and neurological recovery were evaluated.

Results:

Gross total excision was achieved in 48 (80.0%) patients. Favorable MMS grades (I–II) improved significantly from 41.7% preoperatively to 81.7% at 6 months (p<0.001). Mean VAS score decreased from 7.1 ± 1.5 to 2.6 ± 1.1 (p<0.001). Mean blood loss was 285.6 ± 92.4 mL, mean hospital stay was 5.2 ± 1.8 days, and the overall postoperative complication rate was 13.3%.

Conclusion:

Minimally invasive tubular retractor systems provide safe and effective spinal tumor excision with favorable functional recovery and low postoperative morbidity.

Recommendation:

This technique may be considered for appropriately selected patients with spinal tumors.

Author Biographies

Dr.Rahul Deo, Senior Resident, Department of Neurosurgery, IGIMS, Patna, Bihar, India

is a Senior Resident in the Department of Neurosurgery at IGIMS, Patna, Bihar, India. His research interests include spinal oncology, minimally invasive spine surgery, and neurotrauma.
Dr. Anirudha Doshi, Associate Consultant, Department of Neurosurgery, Kokilaben dhirubhai ambani hospital and research centre, India

is an Associate Consultant in the Department of Neurosurgery at Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India. His areas of expertise include spinal surgery, neuro-oncology, and minimally invasive neurosurgical techniques.
Dr. Prathamesh Pathrikar, 3rd Year DrNB Resident, Department of Neurosurgery, Kokilaben Dhirubhai ambani hospital and medical research centre, India

is a 3rd-year DrNB Resident in the Department of Neurosurgery at Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India. His research focuses on spine surgery, neuro-oncology, and clinical outcomes research.
Dr. Sumitkumar Pundlik Bhagat, DrNB Resident, Department of Neurosurgery, Kokilaben Dhirubhai ambani hospital and medical research centre, India

is a DrNB Resident in the Department of Neurosurgery at Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India. His academic interests include minimally invasive spinal surgery, spinal tumors, and neurosurgical research.

References

1. Sinha J, Kankane VK, Shukla A, Sharma A. Clinical and functional outcomes of open versus minimally invasive surgeries in single-level prolapsed intervertebral disc in lumbar region at tertiary care center : A prospective study. ASIAN J Med Sci. 2023;14(9):265-9. https://doi.org/10.3126/ajms.v14i9.53661

2. Bhore E, Nareshbhai PI, Selvapandian S, Vishal K. Clinical Outcome of Minimally Invasive Spine Surgery ( MIS ) Discectomy Using a Tubular Retractor System. J Neonatal Surg. 2025;14(29):515-9.

3. Zhexi He, Cho Ying Li, Calvin Hoi-Kwan Mak, Tat Shing Tse FCC. Minimally Invasive Tubular Retractor Surgery for Intradural Extramedullary Spinal Tumor Reduces Postoperative Degeneration of Paraspinal Muscle. Asian J Neurosurg. 2022;17(1):74-84. https://doi.org/10.1055/s-0042-1749127

4. Mohan Karki, Rakesh Pandey, Manish Vaish, Girish Rajpal, Yaspal Singh Bundela, Hrishikesh Chakrabartty DN. Microscopic Minimal Invasive Resection of Spinal Tumor with Tubular Retractor System : Case Studies of 70 Patients with Literature Review. Asian J Neurosurg. 2025;20(3):491-7. https://doi.org/10.1055/s-0045-1806866

5. Stone DH, Bentz GP, Malley JO, Mccoy L, Sood A, Yakdan S, et al. Clinical Outcomes of Open, Tubular, and Endoscopic Lumbar Discectomy. Spine Open. 2026;2(February):1-6. https://doi.org/10.1097/bn9.0000000000000079

6. Sidhdhapuria P, Pathak A, Rathod J, Rakholiya P. Study of functional outcome of minimally invasive spine surgery through tubular microdiscectomy with laminotomy in case of single level prolapsed lumbar intervertebral disc. Int J Res Orthop. 2026;12(2):421-6. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20260510

7. Pradhanang AB, Jha P, Karki AS, Bohara S, Kumar D. Early Experience of Minimally Invasive Tubular Lumbar Microdiscectomy at a Tertiary Care Centre in Nepal. JIOM Nepal. 2024;46(3):21-5. https://doi.org/10.59779/jiomnepal.1361

8. Gupta V, Gupta P. Functional outcomes after surgery for intradural extramedullary spinal tumors : A retrospective study. Surg Neurol Int. 2026;17(200):1-7. https://doi.org/10.25259/SNI_123_2026