Non-Syndromic Spinal Schwannomas: A Novel Classification

Abstract

Schwannomas are the most frequent primary tumors of the spine with an incidence of 0.3–0.5/100,000 person per year. Current treatment for non-syndromic spinal schwannomas is total resection of the tumor with preservation of neurovascular structures. This study aims to report neurologic and radiologic outcome following treatment of non-syndromic spinal schwannomas along with a novel tumor classification used in our clinic. A retrospective case series was carried out with a patient sample of 82 male and female patients with non-syndromic spinal schwannomas. All patient data were retrospectively collected from the hospital records. As a routine procedure, after admittance and primary evaluation, patients’ tumors were classified using CT or MRI in accordance with our proposed classification method, which employs a dual designation method with tree groups (A, B, and C) for tumor volume and four types (I, II, III, and IV) for tumor localization. Subsequent resection surgery was followed by neurological assessments and follow up at 45th, 180th, and 360th postoperative day. Along with Karnofsky performance status scale, pain, sensory deficits, and motor weakness were scored to assess neurologic recovery. Our finding indicates that patients with different tumor types significantly differ in their neurological scores and show consistent but differential neurological recovery at early and late time points postsurgery. Complications during and postsurgery were minimal, occurring only in two patients. Our findings further reinforce the established safety of total resection operations and indicate that our proposed classification is a simple, effective tool that has proven helpful in preoperative planning and avoiding unnecessary surgical approaches.

Lumbar radiculopathy associated radicular schwannoma: A case report and literature review

“…Schwannomas are the most frequent peripheral nerve sheath tumors, representing one of the primary benign spinal tumors [5] , [6] , [7] , [8] . Generally, they are diagnosed in the fourth or fifth decade of life and affect males and females equally [ 4 , 6 , 7 ]. However, a few studies have recently suggested a slight male predilection [ 4 , 6 ].…”

Giant lumbar spinal schwannoma: a case report and literature review

“…The incidence of spinal schwannomas varies with age. The peak incidence is in the fourth to fifth decade of life [ 9 , 10 ]. There was no reported correlation between the prevalence of this tumor and sex.…”

Synchronous Presentation of a Cervical Spinal Schwannoma and Primary Progressive Multiple Sclerosis in a 65-year-old Man

“…When arising from spinal nerves, radiculopathy is the typical presentation, beginning with dermatomal pain, which may evolve into progressive focal motor weakness as the tumor grows and mass effect increases [10]. MRI findings include a characteristically well-circumscribed, contrast-enhancing mass, with T2 hyperintensity, and frequent involvement of the neural foramen at the level of disease [2]. More than 95% of spinal schwannomas occur sporadically; however, several distinct syndromic presentations are frequently observed [11].…”