Spinal extradural schwannoma

Abstract

<jats:p content-type="fine-print"><jats:italic>Object.</jats:italic> The authors endeavor to define the clinical and surgery-related profile of spinal nerve sheath tumors located in the extradural space outside both the dural sac and, apparently, the nerve roots' sleeve.</jats:p> <jats:p content-type="fine-print"><jats:italic>Methods.</jats:italic> A series of 24 extradural schwannomas was retrospectively selected after reviewing the notes of spinal nerve sheath tumors surgically treated at La Sapienza University of Rome. Clinical data, tumor-related characteristics, and outcome were analyzed.</jats:p> <jats:p content-type="fine-print">Women predominantly harbored these tumors. On admission sensory nerve root dysfunction was infrequently reported, whereas pyramidal tract deficits were often present. The tumor, generally large, was most frequently located in the intermediate thoracic segments and high cervical region; only one was reported in the lumbosacral region. Considerable erosion of vertebral bodies was reported in almost one third of the cases. In four patients eloquent nerve roots, that of C-5 in three and that of S-1 in one, were involved with the tumor. Radical tumor resection, with preservation of the nerve roots, was possible in several cases, whereas in two patients manipulation and resection of the C-5 root produced transient and permanent, respectively, root palsy. At follow-up examination patients for whom walking was impossible before surgery were now able to walk.</jats:p> <jats:p content-type="fine-print"><jats:italic>Conclusions.</jats:italic> Extradural schwannomas can be distinguished from other nerve sheath tumors growing inside the spinal canal by their clinicoradiological features and unlikely nerve root origin. After surgery, recovery from pyramidal tract deficits, even severe, is noteworthy; in the authors' experience, however, resection of an involved appendicular root is more likely to result in a permanent and significant radicular deficit.</jats:p>

Long-term surgical treatment outcomes of spinal schwannomas: retrospective analysis of 49 consecutively operated cases

“…In a review of the literature this percentage ranged between 25% and 33% (3,5,8,10,15,21,22). The literature review showed that there is no significant prevalence difference between males and females (2)(3)(4)(5)22). However, the authors noticed a somewhat higher prevalence in females, accounting for 26 patients (57.1%).…”

“…The incidence of SS varies between 3-4 cases/1,000,000 persons per year (22). SS typically display no gender preponderance while the mean of age of appearance is usually between 40-50 years with the exception of a few cases (2,4,5,22).…”

Clinico-Histopathological Study of Schwannoma at a Tertiary Care Centre, Gwalior

“…There is no significant prevalence difference between males and females [7,8] . The incidence of schwannoma varies with the age of affected patients who are between the 4th and the 5th decade [17] .…”

“…The pain is localized in one (tumor) place, sometimes spread in both sides, mostly temporarily, but constantly in the same place and hurt as a knife. At the beginning the root pain is attributed to the disturbance of nerve conductivity because of the direct or indirect irritation of nerve root or root compression by the tumor [7] . Later on when compression increases to spinal cord, spinal tracts gets damaged and myelopathy develops [18,19] .…”

“…Spinal schwannomas account for about 25% of intradural spinal cord tumors in adults [7,8] . Most are solitary schwannomas, which can occur throughout the spinal canal [9] .…”