Intraoperative Electrophysiologic Studies on the Functions of Nerve Roots Involved in Cervical Dumbbell-shaped Schwannoma and Their Clinical Utility

Abstract

The residual function of motor and sensory nerve roots involved with cervical schwannoma differed between individuals and could be detected using intraoperative electrophysiologic assessment.

Schwannoma of the conus medullaris: a rare case

“…The differential diagnoses of such a large cyst include a cystic schwannoma, cystic neurofibroma, ependymoma, epidermoid cyst, arachnoid cyst, cystic lymphangioma, cysticteratoma, and cystic meningioma[3],[11],[12]. Intraspinal schwannomas have no pathognomonic radiographic features.…”

“…Schwannoma in its classic form consists of spindle-shaped cells with pale, eosinophilic cytoplasm arranged in two characteristic patterns: Antoni A (compact, hypercellular, well-organized spindle cells in a palisading pattern) and Antoni B (hypocellular, loose-textured pleomorphic cells with predominantly myxoid cytoplasm). In addition, schwannomas show diffuse immunoreactivity for S-100 protein[6]–[8],[11].…”

Giant solitary ancient schwannoma of the cervico-thoracic spine: a case report and review of the literature

“…The surgeons can decide upon total resection of a schwannoma without consequent neurological deterioration when it is demonstrated that motor and sensory nerve roots involved in the schwannoma are already less or not functional. In patients with good functioning nerve roots, there is the risk of recurrence of the tumour but partial resection may be indicated to avoid post-operative neurological deterioration 21 . The appropriate surgical approach must be based on an understanding of the underlying anatomy and the type and location of the lesion.…”

Intraoperative Mapping of Roots, Plexuses, and Nerves

“…In addition, tEMG has been used as an intraoperative mapping tool in several other surgeries, some of which are mentioned below. In a small group of patients with cervical schwannoma, Kaneko et al (2006) used tcMEP, tEMG from root stimulation, and SNAP recording from nerve roots following digit stimulation to identify and assess residual function of nerve roots involved in cervical schwannoma. A decrease in the CMAP amplitude after individual nerve root stimulation was used to guide the extent of resection of the tumor.…”