A Purely Paraspinally Located Schwannoma from a Dorsal Root of a Spinal Nerve (original) (raw)
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Neurology Research International, 2017
Background.Spinal schwannomas are common benign spinal tumors. Their treatment has significantly evolved over the years, and preserving neurological functions has become one of the main treatment goals together with tumor resection.Study Design and Aims.Retrospective review focused on clinical assessment, treatment techniques, and outcomes.Methods.A retrospective study on our surgical series was performed. Clinical and operative data were analyzed. In regard to neurophysiologic monitoring, patients were retrospectively divided into two groups comparing the outcomes before and after introduction of routine intraoperative neurophysiology tests.Results.From 1951 to 2010, 367 patients overall were treated. Diagnosis was obtained using angiography and/or myelography (pre-CT era), MRI, or CT scan. A posterior spinal approach was used for most patients; complex approaches were adopted for treatment of giant/dumbbell tumors. A trend of neurophysiology monitoring decreasing the rate of post-...
Extramedullary Intradural Spinal Schwannoma: A Case Report and Successful Treatment Approach
SVOA Orthopaedics, 2023
Studies have shown that extramedullary intradural tumors (EIDTs) can develop from various tissues and structures surrounding the spinal cord, including nerve roots, meninges, or vertebral bodies. Nerve sheath tumors account for approximately 30% of EIDTs in adult, while meningeal tumors account for approximately 25%. The prevailing types of tumors are Schwannomas, accounting for 29% of cases, and gliomas at 22%. We present our 46-year-old female who visited the clinic reporting a persistent upper back pain in the thoracic region for one year. The MRI revealed an EIDT on the right side of the spinal canal at the T6-T7 level which was consistent with a possible diagnosis of schwannoma. This case report highlights the diagnosis, management, and outcome of a patient with schwannoma. Following removal of the extradural portion of the mass, the dura defect was closed by duraplasty. Fortunately, there was no observed loss of function after surgery. This favorable result underscores the critical role of timely and precise diagnosis, meticulous preoperative assessment, and appropriate surgical methods in managing such tumors. This case report on Schwannomas can contribute to our understanding of the disease and help in developing better treatment and management strategies compared to the literature which is still unclear.
Primary Spinal Schwannoma: A Single Center Study Of 37 consecutively Operated Cases
Nepal journal of neuroscience, 2022
Background: Primary spinal Schwannoma (PSS) remains uncommon nerve sheath tumor of the spine with male preponderance and presenting in fourth to fifth decades. They arise from the Schwann cells in sensory root as PSS or part of Neurofibromatosis 2. Methods: This is a retrospective study of histopathologically confirmed cases of PSS treated between 2010 to 2021. They were operated and age, sex, clinic-radiological findings, surgical technique used and outcome studied. Laminectomy or laminoplasty or combined anterior-posterior approach was used with either an intracapsular or extracapsular tumor removal. Follow-up was at 15 days, 2 months, 6 months and yearly intervals. Results: There were 37 cases operated with age ranging from 16 to 81 years and majority in the 21-40-year group (40%) followed by 41 to 60 years (32%). There were 22 males and 15 females. Localized pain in the back or cervical region was the commonest finding (75%) followed by myelopathy in 38%, radiculopathy in 35% and bladder disturbances in 13%. They were most common in the lumbar region (35%) followed by thoracic (30%). With relation to the level and sex, the cervical level showed equal sex distribution while the rest had male preponderance Conclusions: PSS although can frequently present to the spine surgeon and the diagnosis is clinched with help of an MRI. Surgery remains the main modality of treatment either by laminectomy, laminoplasty or minimal invasive spine surgery. The nerve root of origin must be preserved in all that can be aided with help of intraoperative neurophysiological monitoring.
Giant lumbar spinal schwannoma: a case report and literature review
Radiology Case Reports, 2021
We report a case of a 40-year-old female patient admitted to the hospital due to lumbar pain that spread to both legs and was associated with weakness of the lower extremities. Magnetic resonance imaging revealed an intradural-extramedullary tumor at the level of the T12-L2 vertebra. The lesion was over 7 cm in greatest diameter and compressed the conus medullaris. The patient underwent surgery to remove the entire tumor. Postoperative pathology confirmed the diagnosis of schwannoma. The symptoms resolved almost completely without significant complications.
Spinal Schwannoma : Scrutinizing the Armamentarium of a Single Institute
Journal of the Royal Medical Services, 2018
Objectives: To investigate the clinical characteristics, epidemiological features of spinal schwannomas diagnosed at a single institution. Methods: A retrospective study carried out of all consecutives 67-patients presented with spinal schwannoma treated at the neurosurgery department in King Hussein Medical Center. Clinical information, imaging studies, and biopsy results were compiled from all consecutive patients (all cases were included) treated in our setup over a period of 10-years from January 2006 to January 2016. Results: Study cohort consisted of 38-females (56.71%) and 29-males (43.28%), with ages ranging from 17 to 75 years (mean: 41.45 ± 13.74 yr). The most common initial symptom was radicular pain (46 patients, 68.65%). The most common regions of involvement were the lumbar spine (37 patients, 55.22%), followed by cervical (16 patients, 23.88%), thoracic segments (12 patients, 17.91%) and sacral region (2 patients, 2.98%). In the total population of 67-cases, the schwannomas were intradural extramedullary in 65-cases (97.01%) and in 2-cases it was extradural (2.98%). Three cases (4.47%) recurred locally. Conclusion: Spinal schwannomas are benign tumors that can cause significant neurological deficits. Lumbar spine is the most common site of spinal schwannomas according to this study. Surgery for spinal schwannomas usually results in excellent postoperative clinical outcomes. Schwannoma is generally separable from the underlying nerve. In cases of subtotal removal, there could be a recurrence.
Schwannoma of the spinal accessory nerve: a case report
Journal of clinical and diagnostic research : JCDR, 2013
We are reporting a rare case of a schwannoma which originated from the cervical portion of the spinal accessory nerve, which was located in the left posterior triangle of the neck and did not have any neurological deficit, which was diagnosed by the Magnetic Resonance Imaging (MRI) scan and confirmed histopathologically after surgery.
Single root multiple spinal schwannomas: Case report, treatment strategy and review of literature
International Journal of Surgery Case Reports
INTRODUCTION: Schwannomatosis is defined as multiple schwannomas without presence of neurofibromatosis and is a rare pathology. In vast majority of cases the schwannomas grow from different nerve roots or peripheral nerves. PRESENTATION OF CASE: A 52-year-old woman presented with multiple intradural schwannomas arranged in a chain along the spinal canal causing significant compression. The lesions were successfully removed using a left side en-bloc hemilaminectomy technique in order to preserve maximal stability of the posterior column. Back and leg pain resolved completely. Tendon reflexes returned to normal shortly. There was decreased pain sensation in the distribution of the left L3 spinal root. DISCUSSION: The traditional surgical strategy for posterior approach by laminectomy or laminotomy is sometimes complicated with instability or deformation of the vertebral column that requires surgical stabilization. We performed a one side en-bloc hemilaminectomy thus maintaining the integrity of the muscles and ligaments on the opposite side and preserving maximal stability of the vertebral column. Densely adherent tumors required careful sharp dissection and separation under neurosurgical monitoring and stimulation for recognition and preservation of spinal roots. An additional tumor was discovered by exploration of the spinal canal using an endoscope. CONCLUSION: Multiple spinal cord schwannomas that are growing along the same part of the vertebral column can be safely removed by one-sided hemilaminectomy with preservation of the integrity of the muscles and ligaments on the opposite side and thus maintain spinal stability. The 30 • endoscope can be a good tool for visual exploration of the spinal canal.
Management of Spinal Schwannomas in Gabriel Touré Hospital: Review of 11 Cases
Surgical Science
Background: Spinal schwannomas are common tumors of spinal neoplasm and account for about 25% of intradural spinal cord tumors in adults. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. In this report, the authors present the incidence, clinical presentation, localization, and results of surgically treated spinal schwannomas. The results of a literature review are also presented. Methods: Eleven consecutive patients with histologically confirmed spinal schwannomas were treated from January 2013 to December 2016 in the neurosurgical department of Gabriel Touré Hospital, Bamako, Mali. Neuroradiological diagnosis was made, CT scan in 7 patients, and MRI in 4 patients. All patients were operated on via the posterior approach. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists. The patients were followed for 6 to 38 months (mean 28 months). Functional outcome was assessed using the motor grade and sensory change. Results: There were 11 patients with 7 (63.6%) males and 4 (36.4%) females. The mean age was 40.3 years (range 23-62 years). The most common symptom at the time of diagnosis was radicular pain in 9 (81.8%) patients followed by motor weakness in 8 (72.7%) patients. The most frequent site of spinal schwannomas was the thoracic region in 5 (45.5%) patients. During surgery, Gross-total resection was achieved in 8 patients (72.7%) and subtotal removal in 3 (27.3%) patients. Histological findings were benign schwannoma in all How to cite this paper:
Turkish Neurosurgery, 2015
tumors, particularly in adults (8). Rarely, SS have possibility of malignancy and therefore the recommended primary treatment of choice is gross-total resection (GTR) with preservation of neurological function. GTR of these lesions, which is the main goal of surgical treatment, leads to good results. Giant dumbbell SS, which extends anteriorly to invade the bones, vascular structures, and soft tissues and fill the abdominal and thoracic cavities as same as extradural location █ InTRODuCTIOn S pinal schwannomas (SS) are well known, macroscopically solid encapsulated, spindle cell mesenchymal tumors which are called neurinomas in the literature. Although they are mostly benign entities derived from neoplastic schwann cells, SS have possibility of malignant transformation (10,15). SS represent the most common intradural extramedullary lesions, accounting for about one fourth of all nerve sheath AIM: Spinal schwannomas (SS) represent the most common intradural extramedullary lesions, accounting for approximately 24% of all nerve sheath tumors in adults. Schwannomas have infrequent, but existent possibility of malignancy. In this study, long-term outcomes of 49 consecutive SS have been presented. MATERIAL and METhODS: Medical records were retrospectively reviewed in 371 cases of spinal tumors who underwent surgery between the years 2005 and 2014. Cases confirmed as schwannoma histopathologically were included in this study. Patients' complaints, localizations, recurrence rate and complications were evaluated. RESuLTS: Forty-nine cases were detected in 47 (26 female, 21 male) patients. The mean age was 45.8±13.7 years. The mean follow-up period was 61.4±21.5 months. The most common complaint was local pain. Eleven were cervical, ten thoracic, twentyfour lumbar, and four in the sacral spine. Thirty-three cases were intradural-extramedullary, fifteen cases were the extradural type, and one case was the extra-intradural type. Recurrence rate was 4.08%. Gross-total resection (GTR) was achieved in forty-seven patients. The most common complications were surgical site infection and intraoperative instability that were seen in three patients each. Posterior instrumentation was performed in two patients. COnCLuSIOn: SS is mostly benign and intradural-extramedullary. To treat patients with SS, there is no need for adjuvant treatments; GTR with preservation of neurological functions is the best treatment to relieve patients' complaints and to reduce the recurrence rate of SS. To avoid serious complications, we recommend intraoperative neurophysiological monitoring and laminoplasty, especially in young patients. Dumbbell SS may require extensive bone resection. Posterior instrumentation can be used if instability occurs.
Spinal Intraosseus Schwannoma: A Case Report
Surgical Case Reports, 2021
Introduction: Schwannomas are the most frequent extramedullary intradural spinal tumors, accounting for approximately 24% of all nerve sheath tumors in adults. In a lower percentage of cases they may be extradural or transdural (1-19%). Intramedullary schwannomas and intraosseous schwannoma are quite rare tumors representing. Case Description: A 74-year-old woman presented intense low back pain for a few months, associated with left cruralgia and dysesthesia spread to both lower limbs. Magnetic resonance and computed tomography examination demonstrated an extramedullary intradural osteolytic lesion located in the posterior part of the vertebral body and pedicles of L1. The patient underwent a first surgery 4 years earlier with complete removal of the tumor but after about two years she had a recurrence. She was then subjected to a new intervention of decompression, removal of the tumor and arthrodesis. The histological findings were compatible with a classical schwannoma characteriz...