Intraosseous neurilemmoma of the cervical spine causing paraparesis and treated by resection and grafting.

Abstract

SYNOPSIS A neurilemmoma presented as an expanding lesion of the bodies of C6 and C7 vertebrae and caused local neurological signs together with a spastic paraparesis. This tumour was treated by preliminary posterior fusion, followed by its complete removal via an anterior approach and stabilization by anterior spinal fusion. Other cases in the literature are reviewed and discussed.Solitary lesions affecting the vertebral bodies are uncommon and present problems in regard to both diagnosis and treatment. This case report describes how such a lesion was investigated and found at operation to be a neurilemmoma probably arising from within the vertebral body. The

Intraosseous Schwannoma (Neurilemmoma) of the Cervical Spine

“…During a follow-up period of 12 weeks her paraparesis had recovered almost completely. 10 Naidu et al reported an intraosseous schwannoma involving the bodies of the third and fourth cervical vertebrae causing tetraparesis. This patient was also diagnosed with skeletal fluorosis.…”

Schwannoma of T12 Vertebra: Case Report and Review of Literature

“…Although it can appear in any age, the usual age group is the third or fourth decade.There appears no predilection for sex. 2 They have been reported to arise in mandible 3 (most common), sacrum, 4 lumbar, 5 thoracic 6,7 and cervical vertebrae, 8,9 femur, 10 tibia, ® bula, 2 sternum, 11 calcaneum, 12 etc. The reason for the increased incidence in mandible is due to either the long intra-osseous course of the nerve or the increased predilection of schwanomas to the head and neck region, which has a large supply of sensory nerves.…”

“…The schwannoma of the cervical, thoracic and lumbar vertebrae usually present with pain 4,6,7 and/or neurological involvement. 5,8,9 The neurology differs with the level of the lesion.…”

“…8,9 In one of the reported cases of thoracic schwannoma, the patient presented with fractured L1 vertebra following trauma but had the osteolytic lesion (schwannoma) in T12, predisposing to the fracture. 6 In another case of thoracic schwannoma at T8 level, the patient presented with 15 years history of pain.…”

Intraosseous schwannoma of the cervical spine

“…1 Of the seven published cases where the schwannoma arose from within the vertebra, only two have been reported in the cervical region. 3,4 We report a rare case of an intraosseous schwannoma involving the body of the fifth cervical (C5) vertebra that was diagnosed using magnetic resonance imaging following an incidental history of trauma.…”