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J Neurol Surg A Cent Eur Neurosurg 2023; 84(03): 219-226
DOI: 10.1055/s-0041-1739502
Original Article

Minimally Invasive Surgical Technique for the Management of Giant Dumbbell Spinal Schwannoma

Jose Poblete
1   Neurological surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
,
Jaime Jesus Martinez Anda
2   Spine Surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
,
Angel Asdrubal Rebollar Mendoza
3   Neurological Surgery Department, Military School for Public Health Graduates, Army and Air force University of Mexico, Central Military Hospital, Mexico City, Mexico
,
Jorge Torales
1   Neurological surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
,
Alberto Di Somma
1   Neurological surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
,
Ramon Torne
1   Neurological surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
,
Salvador Fuster 
2   Spine Surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
,
Joaquim Enseñat
1   Neurological surgery Department, Faculty of Medicine, Barcelona University, Clinical Hospital, Barcelona, Spain
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Abstract

Background Completely extradural spinal schwannomas have a unique morphology (dumbbell tumors) with an intra- and extraspinal component. When they compromise two contiguous vertebral bodies or have an extraspinal extension >2.5 cm, they are classified as giant spinal schwannomas. The aim of this study is to present our experience in the surgical management of completely extradural giant spinal schwannomas with a minimally invasive approach.

Methods This study is a case series of patients treated at the Neurosurgery Department of the University Clinical and Provincial Hospital of Barcelona, Spain, between January 2016 and December 2019.

Results Fifteen patients met the inclusion criteria, with thoracic and lumbar spines being the most frequent locations. All patients underwent surgical treatment, with a mini-open interlaminar and far-lateral technique. Total gross resection was accomplished in all patients and spine instrumentation was not necessary.

Conclusions Microsurgery is the treatment of choice for spinal schwannomas, and gross total resection with low morbidity must be the surgical goal. Mini-open interlaminar and far-lateral access is a valid surgical option, with low morbidity in experienced hands, and there is no need for spinal instrumentation.

Keywords

spinal tumors - spinal schwannoma - microsurgery - oncology - minimal invasive surgery


Publication History

Received: 03 December 2020

Accepted: 31 May 2021

Article published online:
15 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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