Surgical strategies for removal of intra- and extraforaminal dumbbell-shaped schwannomas in the subaxial cervical spine

Gu, Bon Sub; Park, Jin Hoon; Roh, Sung Woo; Jeon, Sang Ryong; Jang, Jun-Won; Hyun, Seung-Jae; Rhim, Seung Chul

doi:10.1007/s00586-014-3458-9

Cited by 21 publications

(16 citation statements)

References 15 publications

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“…The incidence of dumbbell tumors is 13.71–17.5% in spinal cord tumors [3, 4]. The rate of dumbbell tumors in the cervical spine was significantly higher than that of other spinal segments [5].…”

Section: Introductionmentioning

confidence: 99%

Posterior Hemi-/Laminectomy and Facetectomy Approach for the Treatment of Dumbbell-Shaped Schwannomas in the Subaxial Cervical Spine: A Retrospective Study of 26 Cases

et al. 2017

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Objective: It is difficult to completely and safely remove a tumor that is located in the subaxial cervical spine by using the posterior approach because of the anatomical characteristics. Previous reports regarding the total removal of subaxial schwannomas using the one-stage posterior approach are still limited. This study was to evaluate the feasibility and efficacy of treating the dumbbell-shaped schwannomas in the subaxial cervical spine using the one-stage posterior approach. Methods: Patients with dumbbell-shaped schwannomas in the subaxial cervical spine were treated using the one-stage posterior approach. Surgical profile, clinical outcomes, MRI and X-ray images, and complications were investigated. Japanese Orthopaedic Association (JOA) score and McCormick functional schema score were obtained. Results: The average follow-up was 21.5 ± 5.1 months, with a range of 12–31 months. Twenty-six patients were enrolled in the study. Total resection was achieved in all patients using the one-stage posterior approach with hemi- or laminectomy and facetectomy. All cases underwent lateral mass screw fixation and fusion. JOA improved significantly (p < 0.01). The McCormick score improved significantly (p < 0.05) after the surgery. No mortality, morbidity, or tumor recurrence was observed during the follow-up period. Conclusion: Our technique was feasible and effective for the treatment of dumbbell schwannomas in the subaxial cervical spine. The tumor could be totally removed in most cases safely.

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Section: Introductionmentioning

confidence: 99%

Posterior Hemi-/Laminectomy and Facetectomy Approach for the Treatment of Dumbbell-Shaped Schwannomas in the Subaxial Cervical Spine: A Retrospective Study of 26 Cases

et al. 2017

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“…The preferred method may be tumor resection with laminectomy, with or without posterior stabilization. [7]. In the presented case, posterior stabilization was not preferred; instead, 3-level laminoplasty was performed, and there was no severe kyphosis on control X-ray at the end of the third postoperative month.…”

Section: Discussionmentioning

confidence: 77%

Intradural extramedullary cystic schwannoma of the cervical spine

GÜNDOĞDU

Ekici

2019

The European Research Journal

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Giant cervical intradural extramedullary schwannoma with severe spinal cord compression is a rare entity. Tumor spread and size are very important for surgical approach. In this case, we report a 55-years-old male patient with a giant intradural-extramedullary cervical schwannoma extending between C5 and T1 and causing spinal cord compression that underwent total resection with laminoplasty at C5-6-7 levels. The patient developed no additional deficit. To preserve the cervical lordosis, the patient used a cervical collar for three months. There has been no recurrence during two years of follow-up. Using the appropriate surgical method is essential in patients with spinal tumor in order to avoid additional neurological deficits and achieve cure.

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“…Additionally, another limitation of this study is the lack of quantitative analyses of preoperative and postoperative tumor size. Previous studies measured tumor size as the longest diameter of the tumor on axial MRI [ 7 , 11 , 14 , 21 ] and reported that preoperative and postoperative tumor sizes were not significant risk factors for remnant tumor growth [ 7 , 14 ]. However, discrepancies between measurements of tumor size only on axial MRI and the actual 3-dimensional tumor size were much concerned.…”

Section: Discussionmentioning

confidence: 99%

“…size as the longest diameter of the tumor on axial MRI 7,11,14,21 and reported that preoperative and postoperative tumor sizes were not significant risk factors for remnant tumor growth. 7,14 However, discrepancies between measurements of tumor size only on axial MRI and the actual three-dimensional tumor size were much concerned.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Remnant Tumor Margin as Predictive Factor for Its Growth After Incomplete Resection of Cervical Dumbbell-Shaped Schwannomas

et al. 2022

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Objective:The purpose of our study was to investigate the risk factors of remnant tumor growth after incomplete resection (IR) of cervical dumbbell-shaped schwannomas (DS).Methods: Twenty-one patients with IR of cervical DS with at least 2 years of follow-up were included and were divided into two groups: the remnant tumor growth (G) (n = 10) and no growth (NG) (n = 11) groups. The tumor location in the axial plane according to Toyama's classification, the location of the remnant tumor margin, and MIB-1 index were compared.Results: No significant differences in Toyama's classification and MIB-1 index were found. Age was significantly higher in G group (61.4 vs. 47.6 years; p = 0.030), but univariate logistic regression analysis revealed little correlation to the growth (odds ratio (OR), 1.08; 95% confidence interval (CI), 1.001-1.166; p = 0.047). Seventeen patients (nine in G and eight in NG group) underwent the posterior one-way approach, and significant differences in the location of the remnant tumor margin were confirmed: within the spinal canal in one and zero case, at the entrance of the intervertebral foramen in seven and one cases, and in the foramen distal from the entrance in one and seven cases, in G and NG group respectively (p=0.007). The proximal margin was identified as a significant predictor of the growth (OR, 56.0; 95% CI, 2.93-1072; p = 0.008). Conclusions:Remnant tumors with margins distally away from the entrance of the foramen were less likely to grow after IR of cervical DS.

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Surgical strategies for removal of intra- and extraforaminal dumbbell-shaped schwannomas in the subaxial cervical spine

Abstract: Total removal of intra- and extraforaminal cervical subaxial schwannomas could be possible using a posterior approach with facet removal if the size of extraforaminal tumor was less than 5.4 mm.

Cited by 21 publications

References 15 publications

Posterior Hemi-/Laminectomy and Facetectomy Approach for the Treatment of Dumbbell-Shaped Schwannomas in the Subaxial Cervical Spine: A Retrospective Study of 26 Cases

Posterior Hemi-/Laminectomy and Facetectomy Approach for the Treatment of Dumbbell-Shaped Schwannomas in the Subaxial Cervical Spine: A Retrospective Study of 26 Cases

Intradural extramedullary cystic schwannoma of the cervical spine

Remnant Tumor Margin as Predictive Factor for Its Growth After Incomplete Resection of Cervical Dumbbell-Shaped Schwannomas

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