Endoscopic resection of lumbar intradural spinal tumors: A case series on feasibility, safety, and preliminary outcomes

Background: Intradural spinal tumors are traditionally managed with open microsurgical approaches that provide effective tumor control but involve substantial soft tissue disruption. Although full endoscopic spine surgery is well established for degenerative pathology, its use for intradural tumors remains limited due to challenges related to dural opening, cerebrospinal fluid management, and intradural manipulation. Research question: Can fully endoscopic resection of lumbar intradural extramedullary tumors be performed safely and effectively, and what technical adaptations are required? Methods: A retrospective case series of 10 consecutive patients undergoing uniportal full endoscopic resection of lumbar intradural extramedullary tumors between 2020 and 2024 was analyzed. All procedures were performed via an interlaminar approach by experienced endoscopic surgeons. Operative data, complications, extent of resection, and neurological outcomes were collected. Functional status was assessed using the modified McCormick scale, and postoperative magnetic resonance imaging evaluated extent of resection. Results: The cohort included 6 women and 4 men with a mean age of 58.3 years. Pathology revealed schwannoma (n = 7), meningioma (n = 2), and neurofibroma (n = 1). Gross total resection was achieved in all cases. Mean operative time was 96.5 min, and mean hospital stay was 1.5 days. No intraoperative, cerebrospinal fluid-related, or new neurological complications occurred. Modified McCormick scores improved in 6 patients (60%) and remained stable in 4 (40%). Conclusions: Fully endoscopic resection of selected lumbar intradural extramedullary tumors is feasible and safe when performed by experienced surgeons. Favorable early neurological outcomes can be achieved with careful irrigation control and adapted dural closure techniques.