Purpose: To report two quite rare cases of giant schwannomas of the cervical and thoracic spine. Surgical resection is usually the treatment of choice for these neoplasms. Methods: The first patient is a 48-year-old m...Purpose: To report two quite rare cases of giant schwannomas of the cervical and thoracic spine. Surgical resection is usually the treatment of choice for these neoplasms. Methods: The first patient is a 48-year-old male that came to our department, complaining about weakness and paresthesia of both lower extremities and upper left extremity, and a considerably big dorsal palpable lump. MRI and CT scan were used to diagnose giant cervical schwannoma. Because of the intensity of symptoms, he was subjected to surgery. Multidisciplinary resection involving neurosurgical and oncosurgicalteamn was performed for intravertebral and extravertebral approaches. The second patient is a 55-year-old female that came to the hospital complaining about incapacitating pain and dysesthesia involving T6, T7, and T8 dermatomes, with no other deficits. MRI and CT scan were used to diagnose giant thoracic schwannoma. Because of the intensity of the pain, surgery was decided as the treatment of choice. Video assisted thoracoscopic surgery was performed and total resection was achieved, with improvement of the symptoms. Results: Both patients showed complete remission of the symptoms, with no major deficits after surgery. Conclusion: Although infrequent, giant spinal schwannomas may be the cause of visible lumps in the back with radicular symptoms. When asymptomatic, conservative treatment could be viable, but when they present symptoms, surgery offers good results.展开更多
Background: Spinal schwannomas are common tumors of spinal neoplasm and account for about 25% of intradural spinal cord tumors in adults. They are generally benign and slow-growing. Advanced in radiologic and surgical...Background: Spinal schwannomas are common tumors of spinal neoplasm and account for about 25% of intradural spinal cord tumors in adults. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. In this report, the authors present the incidence, clinical presentation, localization, and results of surgically treated spinal schwannomas. The results of a literature review are also presented. Methods: Eleven consecutive patients with histologically confirmed spinal schwannomas were treated from January 2013 to December 2016 in the neurosurgical department of Gabriel Touré Hospital, Bamako, Mali. Neuroradiological diagnosis was made, CT scan in 7 patients, and MRI in 4 patients. All patients were operated on via the posterior approach. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists. The patients were followed for 6 to 38 months (mean 28 months). Functional outcome was assessed using the motor grade and sensory change. Results: There were 11 patients with 7 (63.6%) males and 4 (36.4%) females. The mean age was 40.3 years (range 23 - 62 years). The most common symptom at the time of diagnosis was radicular pain in 9 (81.8%) patients followed by motor weakness in 8 (72.7%) patients. The most frequent site of spinal schwannomas was the thoracic region in 5 (45.5%) patients. During surgery, Gross-total resec-tion was achieved in 8 patients (72.7%) and subtotal removal in 3 (27.3%) patients. Histological findings were benign schwannoma in all cases. Postoperative complications developed in two patients, including one with cerebrospinal fluid leakage and other one with wound infection. In the short-term follow-up period, most of the patients (90.9%) appeared to be improved in comparison with their preoperative neurological status. There was no operative mortality. Conclusion: In this study, the clinical manifestations and surgical results of 11 cases of spinal schwannoma have been reviewed. Early diagnosis and appropriate treatment are essential for good outcome.展开更多
Background: Spinal tumour has a great morbidity. Objective: The purpose of the present study was to see the outcome of the spinal tumour surgery. Methodology: Patients with spinal tumor have undergone surgery in neuro...Background: Spinal tumour has a great morbidity. Objective: The purpose of the present study was to see the outcome of the spinal tumour surgery. Methodology: Patients with spinal tumor have undergone surgery in neurospine unit of National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from May 2013 to March 2015 for a period of 23(twenty three) months. Plain X-ray and MRI were done in all cases. All patients have undergone surgery through posterior midline approach. They were evaluated preoperatively and at discharge usually on 10<sup>th</sup> postoperative day after stitch removal and advised to attend in follow up clinic after 2 months of surgery. Result: 50 - 59 years age group was observed as most vulnerable for tumor occurrence (23 cases, 47.9%). The male female ratio was 1:1.3. The highest number (28 cases, 58.4%) of tumor was observed in thoracic region but the highest variety was schwannoma (33 cases, 68.7%). Initial presentation of patients was pain (32 cases, 66.7%), motor disturbances (9 cases 18.7%), sensory disturbances (5 cases 10.4%) and sphincter disturbances (2 cases 4.2%). Symptomatic improvement was in 44 (91.7%) patients whereas improvement in Frankel Scale was observed in 10 (20.8%) patients during follow up. 4 (8.4%) patients deteriorated and there was no death in this series. Conclusion: In conclusion, majority of the spinal tumour patients are presented with schwannoma with good symptomatic improvement.展开更多
目的:探讨后路全椎板切除入路手术治疗椎管内神经鞘瘤和脊膜瘤的临床疗效。方法:回顾性分析手术治疗68例椎管内神经鞘瘤和脊膜瘤患者的临床资料,按Frankel神经功能分级和改良Macnab疗效评定标准评价患者的临床疗效,并复查X线片观察脊柱...目的:探讨后路全椎板切除入路手术治疗椎管内神经鞘瘤和脊膜瘤的临床疗效。方法:回顾性分析手术治疗68例椎管内神经鞘瘤和脊膜瘤患者的临床资料,按Frankel神经功能分级和改良Macnab疗效评定标准评价患者的临床疗效,并复查X线片观察脊柱稳定性。结果:68例患者肿瘤均完全切除,经病理确诊神经鞘瘤44例,脊膜瘤24例。术后神经功能分级:Frankel A 1例,Frankel B 0例,Frankel C 4例,Frankel D 24例,Frankel E 39例。症状改善优良率为88.2%。随访期间复查X线片未见明显脊柱不稳征象。结论:经后路全椎板切除术可以最大范围地暴露椎管内肿瘤,利于肿瘤的完全切除,配合椎弓根钉内固定技术重建脊柱稳定性,用于治疗椎管内神经鞘瘤和脊膜瘤,短期内疗效确切。展开更多
文摘Purpose: To report two quite rare cases of giant schwannomas of the cervical and thoracic spine. Surgical resection is usually the treatment of choice for these neoplasms. Methods: The first patient is a 48-year-old male that came to our department, complaining about weakness and paresthesia of both lower extremities and upper left extremity, and a considerably big dorsal palpable lump. MRI and CT scan were used to diagnose giant cervical schwannoma. Because of the intensity of symptoms, he was subjected to surgery. Multidisciplinary resection involving neurosurgical and oncosurgicalteamn was performed for intravertebral and extravertebral approaches. The second patient is a 55-year-old female that came to the hospital complaining about incapacitating pain and dysesthesia involving T6, T7, and T8 dermatomes, with no other deficits. MRI and CT scan were used to diagnose giant thoracic schwannoma. Because of the intensity of the pain, surgery was decided as the treatment of choice. Video assisted thoracoscopic surgery was performed and total resection was achieved, with improvement of the symptoms. Results: Both patients showed complete remission of the symptoms, with no major deficits after surgery. Conclusion: Although infrequent, giant spinal schwannomas may be the cause of visible lumps in the back with radicular symptoms. When asymptomatic, conservative treatment could be viable, but when they present symptoms, surgery offers good results.
文摘Background: Spinal schwannomas are common tumors of spinal neoplasm and account for about 25% of intradural spinal cord tumors in adults. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. In this report, the authors present the incidence, clinical presentation, localization, and results of surgically treated spinal schwannomas. The results of a literature review are also presented. Methods: Eleven consecutive patients with histologically confirmed spinal schwannomas were treated from January 2013 to December 2016 in the neurosurgical department of Gabriel Touré Hospital, Bamako, Mali. Neuroradiological diagnosis was made, CT scan in 7 patients, and MRI in 4 patients. All patients were operated on via the posterior approach. All cases were surgically excised, and they were confirmed to be schwannomas by pathologists. The patients were followed for 6 to 38 months (mean 28 months). Functional outcome was assessed using the motor grade and sensory change. Results: There were 11 patients with 7 (63.6%) males and 4 (36.4%) females. The mean age was 40.3 years (range 23 - 62 years). The most common symptom at the time of diagnosis was radicular pain in 9 (81.8%) patients followed by motor weakness in 8 (72.7%) patients. The most frequent site of spinal schwannomas was the thoracic region in 5 (45.5%) patients. During surgery, Gross-total resec-tion was achieved in 8 patients (72.7%) and subtotal removal in 3 (27.3%) patients. Histological findings were benign schwannoma in all cases. Postoperative complications developed in two patients, including one with cerebrospinal fluid leakage and other one with wound infection. In the short-term follow-up period, most of the patients (90.9%) appeared to be improved in comparison with their preoperative neurological status. There was no operative mortality. Conclusion: In this study, the clinical manifestations and surgical results of 11 cases of spinal schwannoma have been reviewed. Early diagnosis and appropriate treatment are essential for good outcome.
文摘Background: Spinal tumour has a great morbidity. Objective: The purpose of the present study was to see the outcome of the spinal tumour surgery. Methodology: Patients with spinal tumor have undergone surgery in neurospine unit of National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from May 2013 to March 2015 for a period of 23(twenty three) months. Plain X-ray and MRI were done in all cases. All patients have undergone surgery through posterior midline approach. They were evaluated preoperatively and at discharge usually on 10<sup>th</sup> postoperative day after stitch removal and advised to attend in follow up clinic after 2 months of surgery. Result: 50 - 59 years age group was observed as most vulnerable for tumor occurrence (23 cases, 47.9%). The male female ratio was 1:1.3. The highest number (28 cases, 58.4%) of tumor was observed in thoracic region but the highest variety was schwannoma (33 cases, 68.7%). Initial presentation of patients was pain (32 cases, 66.7%), motor disturbances (9 cases 18.7%), sensory disturbances (5 cases 10.4%) and sphincter disturbances (2 cases 4.2%). Symptomatic improvement was in 44 (91.7%) patients whereas improvement in Frankel Scale was observed in 10 (20.8%) patients during follow up. 4 (8.4%) patients deteriorated and there was no death in this series. Conclusion: In conclusion, majority of the spinal tumour patients are presented with schwannoma with good symptomatic improvement.
文摘目的:探讨后路全椎板切除入路手术治疗椎管内神经鞘瘤和脊膜瘤的临床疗效。方法:回顾性分析手术治疗68例椎管内神经鞘瘤和脊膜瘤患者的临床资料,按Frankel神经功能分级和改良Macnab疗效评定标准评价患者的临床疗效,并复查X线片观察脊柱稳定性。结果:68例患者肿瘤均完全切除,经病理确诊神经鞘瘤44例,脊膜瘤24例。术后神经功能分级:Frankel A 1例,Frankel B 0例,Frankel C 4例,Frankel D 24例,Frankel E 39例。症状改善优良率为88.2%。随访期间复查X线片未见明显脊柱不稳征象。结论:经后路全椎板切除术可以最大范围地暴露椎管内肿瘤,利于肿瘤的完全切除,配合椎弓根钉内固定技术重建脊柱稳定性,用于治疗椎管内神经鞘瘤和脊膜瘤,短期内疗效确切。
