A 6-year Observation of Multiple Spinal Schwannomas Before Excision - 1 Case Report -

Ahn, Dong Ki; Jung, Ki Woong; Song, Lei; Choi, Dae Jung; Park, Jun Seong; Gyu, Sang

doi:10.4184/jkss.2003.10.3.277

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…In this study, the closures were performed without additional procedures because all the tumors were easily separated from the dura mater and no recurrence was observed at the last follow-up. With regard to the patient with multiple schwannomas, the 6-year preoperative medical history showed that the Nurick's grade changed from 1 to 2 over the period and the tumor size on the sagittal MRI images increased 2.38% per year at the level of T12 and 12.96% per year at the level of L3, which is contrary to the previous studies that described these schwannomas as benign, slow-growing tumors 8). Schwannomas have been known to grow with displacing nerve fibers laterally rather than invading them.…”

Section: Discussioncontrasting

confidence: 83%

“…With regard to the patient with multiple schwannomas, the 6-year preoperative medical history showed that the Nurick's grade changed from 1 to 2 over the period and the tumor size on the sagittal MRI images increased 2.38% per year at the level of T12 and 12.96% per year at the level of L3, which is contrary to the previous studies that described these schwannomas as benign, slow-growing tumors. 8) Schwannomas have been known to grow with displacing nerve fibers laterally rather than invading them. Even so, complete removal of a schwannoma is only possible when the nerve fibers are also excised in the case of their involvement within the tumor.…”

Section: Discussionmentioning

confidence: 99%

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The Surgical Treatment for Spinal Intradural Extramedullary Tumors

Ahn¹,

Park²,

Choi³

et al. 2009

Clin Orthop Surg

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BackgroundWe wanted to investigate the results of surgical treatment and analyze the factors that have an influence on the neurologic symptoms and prognosis of spinal intradural extramedullary (IDEM) tumors.MethodsThe spinal IDEM tumor patients (11 cases) who had been treated by surgical excision and who were followed up more than 1 year were retrospectively analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade. The pathological diagnosis, the preoperative symptom duration, the tumor location on the sagittal and axial planes and the percentage of tumor occupying the intradural space were investigated. In addition, all these factors were analyzed in relation to the degree of the preoperative symptoms and the prognosis. On the last follow-up, the MRI was checked to evaluate whether or not the tumor had recurred.ResultsThe most common diagnosis was schwannomas (73%), followed by meningiomas (18%). The percentage of tumor occupying the intradural space was 82.9 ± 9.4%. The VAS score was reduced in all cases from 8.0 ± 1.2 to 1.2 ± 0.8 (p = 0.003) and the Nurick's grade was improved in all cases from 3.0 ± 1.3 to 1.0 ± 0.0 (p = 0.005). The preoperative symptoms were correlated with only the percentage of tumor occupying the intradural space (VAS; r2 = 0.75, p = 0.010, Nurick's grade; r2 = 0.69, p = 0.019). One case of schwannoma recurred.ConclusionsThe degree of neurologic symptoms was correlated with the percentage of tumor occupying the intradural space. All the tumors were able to be excised through the posterior approach. The postoperative neurologic recovery was excellent in all the cases regardless of any condition. Therefore, aggressive surgical excision is recommended even for cases with a long duration of symptoms or a severe neurologic deficit.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

The Surgical Treatment for Spinal Intradural Extramedullary Tumors

Ahn¹,

Park²,

Choi³

et al. 2009

Clin Orthop Surg

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“…Nerve sheath tumors, meningiomas, and filum terminale ependymomas account for most extramedullary neoplasm. [4][5][6][7] Most nerve sheath tumors are entirely intradural, but 30% extend through the root sleeve as a dumble tumor with both intradural and extramedullary component. [7] Neurofibromas predominate in NF1, schwannomas are more common in NF2.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] Most nerve sheath tumors are entirely intradural, but 30% extend through the root sleeve as a dumble tumor with both intradural and extramedullary component. [7] Neurofibromas predominate in NF1, schwannomas are more common in NF2. [8] One percent nerve sheath tumors are intramedullary and are thought to arise from perivascular nerve sheath that accompany penetrating spinal cord vessels.…”

Section: Introductionmentioning

confidence: 99%

“…Meningiomas may also arise from pia or dural fibroblast, reflecting there probable mesodermal origin, [3] 75-85% occur in women and about 80% are thoracic. [7] About 40% of spinal canal ependymomas arise within the filum terminale, most in its proximal intradural potrion. In this study we reviewd the clinical and histological aspect of IDEM tumors along with their functional outcome after surgery of all radiologically diagnosed cases of IDEM and there correlation with size.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Outcome in IDEM Tumors in Short Term Follow Up

Kumar¹,

Saha²,

Ghosh³

2017

AIMDR

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Background: To review the clinical and histological aspect of IDEM tumors with functional outcome after surgery of all radiologically diagnosed cases of IDEM. Methods: 12 cases of IDEM tumors, which had been surgically treated and studied in terms of clinical features as pain by VAS, functional score by Nuricks grading, in preoperative and postoperative period. The correlation of histopathology and tumor size in terms of clinical features and outcome was done. Results: Most common diagnosis was schwannoma (83.3%) and rest 2 patients were meningiomas(16.7%), distribution -3(25%) dorsal, 5(41.6%) lumbar, 2(16.6%) cervical, 1(8%) cervico-dorsal and 1(8%) dorso-lumbar and average percentage of the intradural space occupied by tumor was 77.02%. Average age was 40 years. Meningioma was common in 55 to 60 yr age all female; schwannoma the mean age was 37 year. The most common symptoms were local pain, tingling and numbness, motor weakness which were observed in all the cases. All patients improved postoperatively. VAS score and Nurick grade inproved in all. Conclusion: Most common pathology was schwannoma then meningioma. All the tumors excised through the posterior approach. The postoperative recovery was good in all the cases regardless of any condition. Therefore, aggressive surgical excision is recommended even for cases with a long duration of symptoms or a severe neurologic deficit.

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Functional outcomes in intradural extramedullary spinal tumors

Randhawa,

Srivastava,

Agrawal

et al. 2024

Surgical Neurology International

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Background: Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of benign intraspinal neoplasms. These are amenable to gross total excision but can have variable functional outcomes, which plays a key role in assessing their impact on a patient’s quality of life. Understanding the functional outcomes associated with these tumors is crucial for healthcare professionals to devise appropriate treatment plans and provide comprehensive care. Methods: In this study, we retrospectively reviewed the outcomes of 130 patients with IDEM tumors who underwent surgery in the past six years between January 2017 and December 2022 at a single institution. Patient demographics, symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel grading. The back pain was assessed using the Denis pain scale (DPS). Results: The age range, gender distribution, presentation, histopathology, and tumor characteristics were analyzed. The histopathological outcomes of the study were as follows: 56 cases of schwannoma, 37 cases of meningiomas, 16 patients of neurofibroma, six cases of epidermoid cyst, five cases each of ependymoma and dermoid cyst, three cases of arachnoid cyst, two cases of metastasis, and one case of paraganglioma. Pain was the most common symptom (38.5%), followed by weakness in limbs (31.5%), paresthesia/numbness (22.3%), and sphincter disturbance (7.7%). Complete total resection was seen in 93% of cases, with 7% undergoing subtotal excision. The complications encountered were – four cases of surgical site infection and one case each of cerebrospinal fluid leak, pseudomeningocele, and epidural hematoma. In our series, 49.3% of patients had significantly good improvement in functional outcomes as per improvement in Frankel score, and 43% of patients had good functional improvement. Significant functional improvement was noted at immediate postoperative follow-up, 2-week follow-up, and six-month follow-up periods. Reoccurrence was seen in 7 cases (5.4%). The DPS score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significantly poor outcome was seen in IDEM tumours present anteriorly. Conclusion: The IDEM tumors are usually benign and are readily detected by contrast-enhanced magnetic resonance imaging scans. These have variable functional outcomes in different centers. Assessing this functional outcome is an essential aspect of managing IDEM spinal tumors. It was observed through our study that the ventral location of the tumor, thoracic tumors, and poor preoperative neurological status of the patient correspond with poorer postoperative functional outcomes. Furthermore, a significant decrease in the pain symptoms with improvement of Frankel score was seen postoperatively, thus this being suggestive of a significant improvement of functional outcome after surgery. This study helps to conclude that the morbidity associated with the resection of IDEM tumors is not as significant as originally thought to be.

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A 6-year Observation of Multiple Spinal Schwannomas Before Excision - 1 Case Report -

Cited by 3 publications

References 4 publications

The Surgical Treatment for Spinal Intradural Extramedullary Tumors

The Surgical Treatment for Spinal Intradural Extramedullary Tumors

Surgical Outcome in IDEM Tumors in Short Term Follow Up

Functional outcomes in intradural extramedullary spinal tumors

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