[Surgical tactics in hourglass tumors with intravertebral-mediastinal locations]. / Khirurgicheskaia taktika pri opukholiakh v forme pesochnykh chasov intravertebral'no-mediastinal'noi lokalizatsii.

The most expedient surgical tactics in hour-glass tumors of intravertebral-mediastinal localization are discussed. In 10 of 27 cases total removal of the tumor through a vertebral approach proved possible. Total removal of a rather large intrathoracic node by Guleke's method was conducted in 2 cases. In 10 cases with large intrathoracic nodes, total removal of the tumor was carried out by means of a combined intravertebral-thoracic (transpleural) approach suggested by the authors. It is emphasized that multi-stage operations and partial resection of the tumor are inexpedient and that attempts to remove it totally through a thoracic approach only are inadmissible.

[Diagnosis and surgical treatment of hourglass shaped tumors of cervical localization]. / Diagnostika i khirurgicheskoe lechenie opukholei v forme pesochnykh chasov sheinoi lokalizatsii

Among 449 patients with intravertebral tumours, 35 patients (7.8%) had sand-glass shaped tumours, 19 of them being localized in the neck, which comprised 19.6% of the 97 cervical intravertebral tumours, and 45.9% of neurinomas. An analysis of the material permits to conclude that when the symptoms of spinal cord compression are combined with an extension of the intervertebral foramen, the indications for myelography for precising the diagnosis are relative. A one-stage total excision of the tumour is indicated, either via a vertebral approach, or via a bilateral approach by way of laminectomy and from the neck. Whenever the intervention has to be divided into two stages, the intravertebral node should be removed first, and the extra-vertebral one afterwards from the cervical incision, always striving to cut the interval between the two interventions down to 3-4 weeks.