Thoracic Cord Hemangioblastoma

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This video reviews techniques for a section of spinal cord and more specifically Thoracic Hemangioblastoma. This is a 20 year old male suffering from Von-Hippel-Lindau disease who presented with progressive paraparesis. MRI evaluation revealed hemangioblastoma within the thoracic spinal cord, centered more toward the right side associated with a very impressive intraspinal cyst. He subsequently underwent thoracic laminectomies for exposure of the lesion. So much sensory and motor evoked potentials were monitored. The nodule is located here. Epidural hemostasis was secured and the arachnoid bands around the lesion were widely dissected. Dissection continued, exactly at the level of the capsule of the malformation. These lesions are primarily epipial and therefore entry into the parenchyma of the spinal cord should be avoided. Pial membranes at the periphery of the tumor were coagulated and cut. The pial membranes at the periphery of the tumor contained the feeding arteries. Can see the capsule of the hemangioblastoma does not invade the parenchyma of the spinal cord. Circumferential dissection continues. Cottonoid patties can be used to maintain the dissection planes. We continue to go around the periphery of the lesion. One of the final feeding vessels is coagulated and cut, and the lesion is rolled out. Hemostasis is secured. Here's a final view of the operative corridor. Thank you.

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