Reaches of Unilateral Biportal Endoscopy in Lower Thoracic and Lumbar Spinal Extramedullary Tumor Resection: Case Series, Surgical Note, and Outcomes
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors- What segments were included in the thoracolumbar region? Please describe in the methods section. In the results, it says L4- which is not thoracolumbar anymore, I would suggest using lower thoracic and lumbar spine instead of thoracolumbar
- Language editing required
- The illustrative case goes at the end of the results section
- For meningioma cases, please refer to the simpson grading for tumor resection rather than PR and GTR
- How did the patient with the CSF leak become symptomatic?
- Transoperative bleeding: operative blood loss
- Table 3 can be omitted as it only describes the applied statistical test for the values described in Table 2
- Figure 6: Use either A or B; the summarized results are the same
- There is no discussion? Did the authors intentionally omit this part? It is most certainly required!
Language editing is required
Author Response
- What segments were included in the thoracolumbar region? Please describe in the methods section. In the results, it says L4- which is not thoracolumbar anymore, I would suggest using lower thoracic and lumbar spine instead of toracolumbar
-The suggested term was added to the text to improve the clarity of the anatomical location: lower thoracic and lumbar spine. The thoracic and lumbar segments discussed in lines 171 and 172 are specified.
- Language editing required.
- The language has been revised
- The illustrative case goes at the end of the results section
- The location of the clinical case has been changed to the suggested section.
- For meningioma cases, please refer to the simpson grading for tumor resection rather than PR and GTR
- Although we agree that the Simpson scale is more appropriate for meningioma cases, the data review was retrospective, so only data from the PR and GTR scales are available.
- How did the patient with the CSF leak become symptomatic?
- The medical record noted CSF leakage confirmed by the neurosurgery department and initially identified by headache with postural exacerbation, evidence of cerebrospinal fluid leaking from the surgical wound reported by the nursing department, and confirmed as cerebrospinal fluid by the laboratory department.
- Transoperative bleeding: operative blood los
- The suggested term (transoperative bleeding) was added to the text
- Table 3 can be omitted as it only describes the applied statistical test for the values described in Table 2.
- Table 3 has been omitted as suggested.
- Figure 6: Use either A or B; the summarized results are the same.
- We consider that both graphs A and B allow the reader to clearly understand the preoperative and postoperative status presented by the patients in our study.
- There is no discussion? Did the authors intentionally omit this part? It is most certainly required!
- The discussion of the findings in our article begins from lines 263 to line 298.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsTHE PRESENT STUDY IS INFORMATIVE ABOUT A MINIMAL SURGICAL PROCEDURE, UNILATERAL BIPORTAL ENDOSCOPY IN CASE OF EXTRAMEDULLARY TUMORS. DESPITE THE LOW NUMBER OF CASES, THE PAPER DESCRIBED WITH DETAILS ALL STEPS OF THIS APPROACH, WITH CLEAR FIGURES AND EXCELLENT TABLES. I THINK THAT A SECTION DISCUSSION IS NEEDED IN ORDER TO HAVE A COMPLETE WORK ADDING A FEW IMPROVEMENTS IN LANGUAGE.
Comments on the Quality of English Languagemost of the knowledge speaks about,is usually sufficient for basic UBE work5,6,7, we recommend take ap and lateral image to confirm the location, this to achieve a better movement on the tissues and flexibility, The patient was positioned on a classic prone on a radiolucent operating table. We arm the operating room in a classical way for biportal endocopy surgery, traction with rootons, we will describe ich type of tumor
The English could be improved to more clearly express the research.
Author Response
THE PRESENT STUDY IS INFORMATIVE ABOUT A MINIMAL SURGICAL PROCEDURE, UNILATERAL BIPORTAL ENDOSCOPY IN CASE OF EXTRAMEDULLARY TUMORS. DESPITE THE LOW NUMBER OF CASES, THE PAPER DESCRIBED WITH DETAILS ALL STEPS OF THIS APPROACH, WITH CLEAR FIGURES AND EXCELLENT TABLES. I THINK THAT A SECTION DISCUSSION IS NEEDED IN ORDER TO HAVE A COMPLETE WORK ADDING A FEW IMPROVEMENTS IN LANGUAGE.
-We appreciate your comments. We would like to clarify the discussion of our findings in our article begins from lines 263 to line 298.
The language has been revised
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsA few comments have not been addressed:
- Transoperative bleeding is not (!) the valid term, please refer to "operative blood loss" as suggested during the last review
- GTR/ PR can also retrospectively be translated into Simpson grading, by looking at the operative notes. Therefore, the explanation that it is retrospective data shouldn't allow the authors to ommit it.
- English is better, but still has some potential for improvement: a few examples "The GTR was achieved ", "Regarding neurological status, all patients", in the technical description past sentences and present are used- please stick to one "tep 1 — The incision was marked as previously described. In all cases, the incision 97 was performed with a #20 scalpel blade oriented at 90° to the fluoroscopic landmarks. We 98 perform this same incision in the fascia and angle the scalpel in a cephalo-caudal direction 99 to open the muscular tissue and facilitate the creation of the working space for continuous 100 water flow without increasing pressure in the surgical chamber [9]. 101 Step 2 — The 30° biportal endoscope (or standard 30° arthroscope) and working in- 102 struments were introduced directly, without the use of serial dilators. This saves time and 103 preserves tissue integrity by minimizing disruption during the creation of the working 104 space. 105 Step 3 "
Author Response
Transoperative bleeding is not (!) the valid term, please refer to "operative blood loss" as suggested during the last review.
-The term “transoperative bleeding” has been replaced by “operative blood loss.”
GTR/ PR can also retrospectively be translated into Simpson grading, by looking at the operative notes. Therefore, the explanation that it is retrospective data shouldn't allow the authors to ommit it.
-The resection scale has been translated in accordance with the parameters established in the Simpson scale.
English is better, but still has some potential for improvement: a few examples "The GTR was achieved ", "Regarding neurological status, all patients", in the technical description past sentences and present are used- please stick to one.
-The verb tense conjugation in the manuscript has been corrected.
Author Response File: Author Response.pdf
