Abstract: Objective To evaluate the feasibility, safety and effect of resection large spinal-retroperitoneal dumbbell tumor tangled with vital abdominal organs through independent posterior approach. Methods 18 patients' clinical data, operation records, pathologic examination results and follow-up data were included in this retrospective analysis. In the initial 8 patients, combined surgical approaches from back and front were used. The later 10 patients were operated on using an independent improved posterior approach to remove tumor. Results In earlier 8 patients who underwent a combined surgery from posterior and antero-lateral approaches, total surgical time averaged 5 hours, the blood loss averaged 800 mL. 1 patient died of brain metastasis 5 months post-surgically. 7 cases symptoms disappeared, no tumor recurrence. In later 10 patients, only independent posterior approach was used, operative time averaged 3 hours, blood loss averaged 450 mL. All patients were not tumor recurrence and symptoms disappear. Conclusion Primary large dumbbell tumor in lumbar region which tangles with abdominal organ can be safely removed through independent posterior approach. Compared with combined posterior and anterior approaches, independent posterior approach is more simple, less traumatic, and similarly effective.

Key words: lumbar spine, primary large dumbbell tumor, abdominal organ involvement, tumor resection, combined posterior and anterior approach, independent posterior approach