Abstract
This study aim to compare the clinical efficacy and postoperative complications total incidence rates of the thoracoscopic resection through the trans-thoracic posterior approach thoracic paravertebral dumbbell-shaped schwannoma with the traditional posterior median approach, in order to provide a reference for clinical treatment. This study was a retrospective cohort study. A total of 265 patients with thoracic paravertebral dumbbell-shaped schwannoma in our hospital from January 2020 to December 2024 were retrospectively included as the research subjects. According to the actual surgical method received, patients were divided into the experimental group (n=130) and the control group (n=135). The patients in the experimental group received thoracoscopic resection through the transthoracic posterior approach, while the patients in the control group received traditional posterior median approach. All patients were followed up for 12 months, 24 months, and 36 months after surgery. The baseline data, primary outcome indicator (total incidence rate of postoperative complications), and secondary outcome indicators (surgical basic conditions, degree of surgical resection, pathological results, and changes in patient efficacy indicators throughout the follow-up period, and total recurrence rate of thoracic paravertebral dumbbell-shaped schwannoma) were compared and analyzed between the experimental group and the control group. The total incidence rate of complications in the experimental group was lower than that in the control group (P<0.05). The average operation time, postoperative ambulation time, average incision length, and average blood loss of the patients in the experimental group were all lower than those in the control group (P<0.05). The degree of surgical tumor resection was higher than that in the control group (P<0.05). There was no statistically significant difference in the postoperative pathological results between the two groups (P>0.05). At different follow-up times, the Japanese Orthopaedic Association (JOA) score and the 36-Item Short Form Health Survey (SF-36) score of the experimental group were higher than those of the control group (P<0.05), while the visual analogue scale (VAS) score was lower than that of the control group (P<0.05). There was no statistically significant difference in the American Spinal Injury Association (ASIA) grade and McCormick spinal function grade between the two groups (P>0.05). The JOA score, SF-36 score, and ASIA grading of all patients in both groups gradually increased with the increase of follow-up time (P<0.05), while the VAS and McCormick grade gradually decreased with the increase of follow-up time (P<0.05). During the 36 month follow-up time, the total recurrence rates of thoracic paravertebral dumbbell-shaped schwannoma were 0 in both groups. Compared with traditional posterior midline approach surgeries, the thoracoscopic resection through the transthoracic posterior approach had better efficacy and a lower total incidence rate of postoperative complications.