Spinal Neurofibromas: A Report of 66 Cases and a Comparison with Meningiomas

Levy, Walter J.; Latchaw, John P.; Hahn, Joseph F.; Sawhny, Buphinda; Bay, Janet W.; Dohn, Donald F.

doi:10.1227/00006123-198603000-00013

Cited by 149 publications

(108 citation statements)

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“…The spinal roots giving rise to extramedullary tumours are frequently non-functional at the time of surgery and the risk of post-operative neurological deficit is, therefore, small when these roots are sacrificed [17,20]. Some authors advise an aggressive surgical approach [8,9,17,20] but we adopt a different stance with the minimum bone removal to maintain spinal column stability and avoid the need for instrumentation, which makes post-operative MRI interpretation difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors advise an aggressive surgical approach [8,9,17,20] but we adopt a different stance with the minimum bone removal to maintain spinal column stability and avoid the need for instrumentation, which makes post-operative MRI interpretation difficult. Only three patients deteriorated post-operatively, two remained ambulant, and one patient, who initially improved, developed MRSA meningitis leading to paralysis.…”

Section: Discussionmentioning

confidence: 99%

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Outcome predictors and complications in the management of intradural spinal tumours

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcome predictors and complications in the management of intradural spinal tumours

et al. 2005

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“…1,6,12,13 The surgical results for such tumors in this study are generally satisfactory and coincides with other studies. 1,11,17,18 All of our cases with cord related motor deficit showed good degree of improvement without any case with new neurological deficit secondary to spinal cord manipulation. On the other hand, we have two cases with postoperative new radicular weakness that follow complete removal of large dumb-bell tumors.…”

Section: Clinical Outcomementioning

confidence: 57%

Cervical Spine Nerve Sheath Tumor: Surgical Experience of a Clinical Case Series

Eissa¹,

El-Fol²

2013

Egyptian Spine Journal

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Background Data: Cervical spine nerve sheath tumors (SNTSs) represent a special location of interest and challenge for neurosurgeons because the lesion in this region tend more to have extradural and extraspinal component (dumb-bell tumors) than dorsal or lumbar region. These tumors extension is most likely because of short intraduradural root in the cervical region. Dumb-bell tumors require special surgical strategy and approaches to allow complete removal of these tumors from both intraspinal and extraspinal components without traction on the spinal cord. Purpose: to evaluate our experience in management of cervical spinal nerve sheath tumors with special consideration for dumb-bell tumors that operated by multidisciplinary team and discussing our result. Study Design: A prospective descriptive clinical case study. Patients and Methods:This was a prospective study including nine patients suffering from cervical spinal nerve sheath tumors who were treated from January 2006 to December 2012. Each case was analyzed according to sex, age, clinical presentation, magnetic resonance imaging (MRI) of the brain and whole spine, surgical intervention, pathology and outcomes. The patients were followed in our outpatient clinic, where they were assessed clinically and functionally by VAS score and JOA score as well as radiologically by MRI of the cervical spine. Results: There were nine cases in this study with cervical SNTSs with age ranged from 30 to 56 years in eight cases with one case reported at 6 years. There were 5 females and 4 males. Five cases in this study (56%) were dumb-bell tumors and four cases were only intraspinal. All dumb-bell tumors were operated by combined posterior and anterior approach at the same session. Six cases (67%) were schwannoma, two cases (22%) were neurofibromas and one case was malignant nerve sheath tumor. The results were generally good. 80% of patients with preoperative pain (78%) had moderate to complete pain relive. All cases with preoperative cord related motor deficit (56%) had improvement to satisfying degree. Conclusion: SNTSs are uncommon lesions and tend to have extradural component in the cervical region. Proper clinical and radiological evaluation should be performed to exclude Neurofibromatosis 1 or 2 with associated spinal and /or intracranial tumors. Multidisciplinary team management provides optimum result for removal of dumb-bell tumors but the posterior approach should be performed first to prevent neurological manipulation. The incidence for recurrence and reoperation of small residual tumor are generally low. (2013ESJ059)

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“…The extradural localization is less common. 3 Dumbbell schwannomas have been reported as a separate group of spinal tumors, which characteristically involve both the intra and the extradural compartments, occupying the intervertebral foramen. Such tumors are most frequently located in the cervical segment of the spine, but the existing literature reports only a few cases of giant lesions extending to different vertebral levels.…”

mentioning

confidence: 99%

Surgical nuances on the treatment of giant dumbbell cervical spine schwannomas: description of a challenging case and review of the literature

Iacopino

Giugno

Gulì

et al. 2016

Spinal Cord Ser Cases

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We report a case of a giant intra and extradural cervical schwannoma in a patient affected by a severe myelo-radiculopathy. Clinical features, diagnosis and the issues concerning the surgical management of this benign tumor are discussed. We also review similar cases previously reported in the literature. A 50-year old caucasian woman was complaining of a 1 year of neck pain and worsening motor impairment in all four limbs causing the inability to walk. Neuroradiological assessment revealed a suspected schwannoma involving the nerve roots from C3 to C5, compressing and deviating the spinal cord. The vertebral artery was also encased within the lesion, but still patent. A posterior cervical laminectomy with a microsurgical extradural resection of the lesion was performed. Moreover, an accurate dissection of the lesion from the vertebral artery and the resection of the intraspinal component was achieved. Vertebral fixation with screws on the lateral masses of C3, C5 and C6 and a hook on C1 was performed. The procedure was secured using electroneurophysiological monitoring. A progressive improvement of the motor functions was achieved. A cervical post-contrast MRI revealed optimal medullary decompression and a gross-total resection of the lesion. Schwannomas are benign, slowly growing lesions which may cause serious neurological deficit. Early diagnosis is necessary and it maybe aided by imaging studies such as MRI or CT. The accepted treatment for these tumors is surgical resection and, when indicated, vertebral fixation. (2016) Spinal schwannomas are benign slow-growing tumors, representing~30% of all primary spinal cord tumors. Schwannomas more frequently (70%) arise from sensory root, rather than motor roots (20%). Rarely, 10% of their origin is undefined or from both motor and sensory roots. Spinal Cord Series and Cases1,2 The vast majority of spinal schwannomas are intradural. The extradural localization is less common.3 Dumbbell schwannomas have been reported as a separate group of spinal tumors, which characteristically involve both the intra and the extradural compartments, occupying the intervertebral foramen. Such tumors are most frequently located in the cervical segment of the spine, but the existing literature reports only a few cases of giant lesions extending to different vertebral levels. [4][5][6] Moreover, the cervical localization of an extradural schwannoma may raise several issues related to the extended involvement of the extradural neural vascular structure, such as the high spinal nerve roots and the vertebral artery.The aim of this report is to describe the successful surgical management of these kind of lesions, focusing on the pre-operative planning and surgical management. The role of new technologies in supporting these surgical procedures, as well as, the importance of knowledge of the anatomic and pathological features of these lesions will be emphasized.A 50-year-old lady was admitted to our institution complaining of neck pain, moderate weakness of the left arm, severe weakness in...

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Spinal Neurofibromas: A Report of 66 Cases and a Comparison with Meningiomas

Cited by 149 publications

References 0 publications

Outcome predictors and complications in the management of intradural spinal tumours

Outcome predictors and complications in the management of intradural spinal tumours

Cervical Spine Nerve Sheath Tumor: Surgical Experience of a Clinical Case Series

Surgical nuances on the treatment of giant dumbbell cervical spine schwannomas: description of a challenging case and review of the literature

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