Total resection of presacral giant schwannoma via minimally invasive dorsal approach: illustrative case

Feigl, Guenther C.; Jugović, Domagoj; Staribacher, Daniel; Buslei, Rolf; Kuzmin, Dzmitry

doi:10.3171/case21319

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…This allows for direct access to the lesion and prevents the need for any bony removal or paraspinal muscle damage. 1 , 2 …”

Section: Transcriptmentioning

confidence: 99%

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Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors

Deora,

Nagesh

2023

Neurosurgical Focus: Video

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Cervical schwannoma excision usually involves laminectomy and violation of the facet joints that necessitates the need for fusion with consequent loss of cervical mobility. The authors present the first video demonstration of an excision of the cervical schwannoma at the C1–2 level using minimally invasive spine tubular retractors, which allows direct access to the lesion and prevents the need for any bony removal. It also preserves the paraspinal muscles, which are important for spinal stability, especially at the C2 level. Special attention is given to incision planning and preoperative image analysis for preventing injury to critical neurovascular structures at this level.

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“…This allows for direct access to the lesion and prevents the need for any bony removal or paraspinal muscle damage. 1 , 2 …”

Section: Transcriptmentioning

confidence: 99%

“…This allows for direct access to the lesion and prevents the need for any bony removal or paraspinal muscle damage. 1,2 1:41 Positioning and Placement of Monitoring Electrodes. The patient was taken to the operating room and placed prone, and the head fixed in the neutral position using Mayfield three-pin head holder.…”

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confidence: 99%

Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors

Deora,

Nagesh

2023

Neurosurgical Focus: Video

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“…The slow growth of these benign tumors is always accompanied by enlargement of bone holes and channels. 12 This therefore opens up the possibility of applying a minimally invasive dorsal approach. In this case, the enlarged bone channel serves as a good surgical corridor.…”

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confidence: 97%

Minimally Invasive Dorsal Approach for the Treatment of Giant Presacral Schwannomas

Feigl

Britz

Staribacher³

et al. 2023

Operative Neurosurgery

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BACKGROUND: The treatment of giant presacral schwannomas is currently a grand challenge for neurosurgeons. Although these tumors are benign and do not infiltrate the surrounding tissues, it is difficult to choose the best surgical approach because they are surrounded by the pelvic organs and great vessels. There is no universally accepted approach to the surgical treatment because giant presacral schwannomas are rare in the population. The anterior approach through laparotomy is more often recommended in the literature. A dorsal approach that involves laminotomy and stabilization is also described in the literature. However, these approaches are rather traumatic for the patient and have both intraoperative and postoperative risks. OBJECTIVE: To report a minimally invasive dorsal approach for the treatment of giant presacral schwannomas. METHODS: We present a fundamentally new approach to the treatment of these tumors using a minimally invasive dorsal approach, based on the specific anatomy and growth of giant presacral schwannomas. This approach is using the potential of modern neurosurgery. RESULTS: We describe 2 cases of successful total tumor resection using this novel surgical approach. No complications have been registered after the surgery. CONCLUSION: A minimally invasive dorsal approach for the treatment of giant presacral schwannomas is sufficient for complete tumor removal, minimizes intraoperative and postoperative risks, is associated with good cosmetic effect, and can be successfully applied in surgical practice.

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The results of surgical treatment of sacral schwannomas with extension into pelvic cavity

Pendyurin

Vasilyev

Копылов

2023

Acta biomedica scientifica

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The aim. To analyze the results of surgical treatment of sacral schwannomas with their extension into lower pelvis.Materials and methods. We analyzed the clinical results of surgical treatment of 25 patients with sacral schwannomas, including those with ventral extension and growth into pelvic cavity. All patients were operated at the Clinic of Neurosurgery of the Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan for a 10-year period. The analysis of literature describing prevalence, classification, diagnosis and surgical treatment of sacral tumors and schwannomas in particular was carried out. The features of the course, diagnosis and surgical treatment of sacral schwannomas and accepted surgical methods for their treatment are described.Results. The average follow-up period of the patients in our study was 61.6 ± 2 months. Compared with the initial indicators of patients in the postoperative period (1 year after the surgery), a good clinical result with the regression of symptoms was registered in 17 (68 %) out of 25 patients, and 10 (40 %) of them had a significant regression of neurological disorders. 3 (12 %) operated patients had a deterioration of neurological disorders in the form of aggravation of sensitive disorders; one patient had an aggravation of pelvic organ dysfunction. Radical removal of the tumor was achieved in 24 (96 %) out of 25 cases; subtotal resection was performed in 1 (4 %) patient. The number of relapses and continued growth of tumors in our series was 12 % (3 out of 25 patients). The mortality rate was 0 %. The complications were registered in 3 (12 %) cases and manifested as wound liquorrhea in cases of using posterior approach.Conclusion. The degree of radicality of tumor resection and clinical outcomes is directly related to the selected surgical approach.

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Total resection of presacral giant schwannoma via minimally invasive dorsal approach: illustrative case

Cited by 4 publications

References 13 publications

Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors

Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors

Minimally Invasive Dorsal Approach for the Treatment of Giant Presacral Schwannomas

The results of surgical treatment of sacral schwannomas with extension into pelvic cavity

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