Mixed approach thoracic – neurosurgery in neurogenic tumors of the posterior mediastinum

The posterior mediastinum, a term synonymous with the paravertebral sulci, is the potential space situated along each side of thevertebral column and adjacent proximal portions of the ribs. The most commonly encountered posterior mediastinal tumors are the neurogenic tumors accounting for 75% of them. The posterior mediastinal tumors may extend into the spinal canal via the intervertebral foramen(dumbbell tumors). These ones account for 10% of the posterior mediastinal tumors and 10% of them are malignant. Due to their presence in two distinct anatomic regions, the thorax and spinalcanal, the surgical treatement of dumbbell tumors require a multidisciplinary approach: thoracic surgeon and neurosurgeon. We present the experience of the Thoracic Surgery Clinic in thesurgery of posterior mediastinal tumors with extension into the spinal canal throughout a 9 year period (2001 – 2010). Seven cases admitted and operated in this period are being analysed.The paper discusses the pathogenic mechanisms, symptoms, diagnosis and treatment of posterior mediastinal tumors with extension into the spinal canal.