Lumbar Intramuscular Myxoma: Microsurgical Resection Using Endoscopic QEVO Assistance

Introduction: Intramuscular myxomas (IM) are rare benign neoplasms of fibroblastic origin, typically presenting in adults, with a female predominance. IMs are commonly located in the skeletal muscles, most frequently in the thighs, but rarely in the paraspinal region. The primary research question addressed is: Can endoscopic assistance in spinal surgeries improve the resection of deep-seated intramuscular myxomas in the lumbar region?

Methods: A case report of a 66-year-old woman with progressive lower back pain and radicular symptoms due to a paraspinal intramuscular myxoma was reviewed. Initial conservative management failed, and the patient underwent a minimally invasive microsurgical resection assisted by a 45° endoscopic microinspection device (Qevo®) to enhance visualization and access the lateral compartment of the tumor.

Results: Complete tumor resection was achieved without complications. The patient reported full resolution of symptoms and remained asymptomatic two years post-surgery. Histopathological analysis confirmed the diagnosis of intramuscular myxoma, with focal CD34 positivity and low Ki67 expression (1%).
This case demonstrates the value of integrating endoscopic tools in spinal surgery, particularly in cases where conventional microsurgical techniques are insufficient for complete tumor resection. The enhanced visualization provided by the 45° endoscope facilitated the successful resection of a paraspinal lesion, improving surgical precision and patient outcomes.

Conclusion : Endoscopic assistance in spinal surgeries offers a significant advantage in resecting paraspinal tumors, especially in anatomically challenging regions. This case underscores the value of endoscopic techniques as a complementary tool to microsurgery, exemplifying the evolving landscape of neurosurgery.