Giant Spinal Schwannomas

Ahmet Öğrenci, Orkun Koban, Salim Şentürk, Onur Yaman, Mehdi Sasani, Sedat Dalbayrak and Ali Fahir Özer

Department of Neurosurgery, Nörospinal Akademi, Turkey
Department of Neurosurgery, Koç University, Istanbul, Turkey

^*Correspondance to: Ahmet �?renci 

 PDF  Full Text DOI: 10.25107/2474-1647.1593

Abstract

Introduction: Spinal schwannomas constitute up to 30% of all spinal tumors and they are usually located at intradural extramedullary region (72%). Schwannomas may also be located extradurally (13%), intradural and extradural (13%) and intramedullary (1%). They originated from the schwann cell and they grow very slowly. They are usually solitary and most of them are located in the lumbar region. Many criteria have been described spinal giant schwannomas location, shape and sizes.Materials and
Methods: We evaluated spinal giant schwannomas cases retrospectively that were operated between 2005 and 2012. There were 13 spinal giant schwannoma cases. We evaluated patient preoperative and postoperative pain with Visual Analog Scale (VAS). We also examined patients’ preoperative and postoperative neurological statue.Results: Five of the 13 patients were male and 8 were female. Mean age was 47.8 for male and 48.8 for female, 5 cases were located at cervical, 3 at thoracic, 3 at lumbar, 1 at presacral, 1 at lumbosacral region. Pain was the common symptom of the patients (92.3%). Neurological deficit and numbness were other most common symptoms. Minimum spinal giant schwannoma was about 3 cm × 2 cm × 3 cm and maximum was about 10 cm × 10 cm × 12 cm size. Neurological deficit and pain were correlated with spinal giant schwannomas diameter. We performed stabilization only in 2 patients. One of them had deformity at the thoracic region and recurrence mass of schwannoma. The other had a widely lytic lesion at lumbosacral region. So we have done reconstruction with stabilization after excision. Rest of the patients treated with only excision. Pain decreased and neurological status was improved following the surgery.Conclusion: Surgical treatment is the common treatment for spinal giant schwannomas. Neural decompression is the first aim of the surgery. And gross total resection of the spinal giant schwannomas improves neurological statue. Approach and type of the surgery depends according to the location of the schwannoma. In some cases transforaminal approach will provide an area to remove the mass. Also in some case only laminectomy will be enough to remove the spinal giant shwannoma. Some cases may need instrumentation and stabilization.

Keywords

Giant; Spinal schwannoma; Neurological

Cite the article

�?renci A, Koban O, ?ent�rk S, Yaman O, Sasani M, Dalbayrak S, et al. Giant Spinal Schwannomas. Clin Surg. 2017; 2: 1593.