Summary
Objective. Surgical exposure of peripheral lumbar schwannomas often requires extensive muscle mobilization which results in significant postoperative pain. We describe an alternative minimally invasive surgical technique for the treatment of such lesions.
Methods. We report the case of a patient with an extradural intraradicular schwannoma of the L4 root that was treated with a minimally invasive transmuscular approach by using tubular retractors.
Results. Muscle trauma and intraoperative blood loss were negligible. The postoperative course was uneventfull. There was no additional morbidity associated with the approach. The patient was discharged 72 h after the procedure.
Conclusions.In selected cases extradural intraradicular lumbar schwannomas can be treated adequately with a minimally invasive transmuscular approach.
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FL Acosta SuffixJr HE Aryan J Chi AT Parsa CP Ames (2007) ArticleTitleModified paramedian transpedicular approach and spinal reconstruction for intradural tumors of the cervical and cervicothoracic spine: clinical experience Spine 32 IssueID6 E203–E210 Occurrence Handle17413461 Occurrence Handle10.1097/01.brs.0000257567.91176.76
P Celli (2002) ArticleTitleTreatment of relevant nerve roots involved in nerve sheath tumor: removal or preservation Neurosurgery 451 684–692 Occurrence Handle10.1097/00006123-200209000-00012
P Celli G Trillo L Ferrante (2005) ArticleTitleExtrathecal intraradicular nerve sheath tumors J Neurosurg Spine 3 1–11 Occurrence Handle16122015 Occurrence Handle10.3171/spi.2005.3.1.0001
G Datta KK Gnanalingham D Peterson N Mendoza K O’Neill A Mcgregor SP Hughes (2004) ArticleTitleBack pain and disability after lumbar laminectomy: is there a relationship to muscle retraction Neurosurgery 54 1413–1420 Occurrence Handle15157298 Occurrence Handle10.1227/01.NEU.0000124751.57121.A6
BH Guiot LT Khoo RG Fessler (2002) ArticleTitleMicroendoscopic decompressive laminotomy for the treatment of lumbar stenosis Spine 27 432–438 Occurrence Handle11840112 Occurrence Handle10.1097/00007632-200202150-00021
T Jinnai T Koyama (2005) ArticleTitleClinical characteristics of spinal nerve sheath tumors: analysis of 149 cases Neurosurgery 56 510–515 Occurrence Handle15730576 Occurrence Handle10.1227/01.NEU.0000153752.59565.BB
JE O’Toole KM Eichholz RG Fessler (2006) ArticleTitleMinimally invasive approaches to vertebral column and spinal cord tumors Neurosurg Clin N Am 17 491–506 Occurrence Handle17010899 Occurrence Handle10.1016/j.nec.2006.06.006
DS Rosen JE O’Toole KM Eichholz M Hrubes D Huo FA Sandhu RG Fessler (2007) ArticleTitleMinimally invasive lumbar spinal decompression in the elderly: outcomes of 50 patients aged 75 years and older Neurosurgery 60 503–509 Occurrence Handle17327795
FA Sandhu P Santiago RG Fessler S Palmair (2004) ArticleTitleMinimally invasive surgical treatment of lumbar synovial cysts Neurosurgery 54 107–111 Occurrence Handle14683546 Occurrence Handle10.1227/01.NEU.0000097269.79994.2F
KM Scheufler H Dohmen VI Vougioukas (2007) ArticleTitlePercutaneous lumbar interbody fusion for the treatment of degenerative lumbar instability Neurosurgery 60 203–212 Occurrence Handle17415155 Occurrence Handle10.1227/01.NEU.0000255388.03088.B7
R Schultheiss G Gullota (1993) ArticleTitleResection of relevant nerve roots in surgery of spinal Neurinomas without persisting neurological deficit Acta Neurochir (Wien) 122 91–96 Occurrence Handle10.1007/BF01446992 Occurrence Handle1:STN:280:DyaK3szisFCnsw%3D%3D
N Sehati LT Khoo LT Holly (2006) ArticleTitleTreatment of lumbar synovial cysts using minimally invasive surgical techniques Neurosurg Focus 20 IssueID3 E2 Occurrence Handle16599418 Occurrence Handle10.3171/foc.2006.20.3.3
T Sihvonen A Herno L Paljävri O Airaksinen J Partanen A Tapaninaho (1993) ArticleTitleLocal denervation atrophy of paraspinal muscles in postoperative failed back syndrome Spine 18 575–581 Occurrence Handle8484148 Occurrence Handle10.1097/00007632-199304000-00009 Occurrence Handle1:STN:280:DyaK3s3kvVGqug%3D%3D
H Taylor AH Mcgregor S Mehdi-Zadeh S Richard N Kahn JA Zadeh SP Hughes (2002) ArticleTitleThe impact of self-retaining retractors on the paraspinal muscles during posterior spinal surgery Spine 27 2758–2762 Occurrence Handle12486343 Occurrence Handle10.1097/00007632-200212150-00004
TL Trendway P Santiago MR Hrubes JK Song SD Christie RG Fessler (2006) ArticleTitleMinimally invasive resection of intradural-extramedullary spinal neoplasms Neurosurgery 58 ONS52–ONS58
R Vialle C Court N Khouri E Olivier L Miladi JL Tassin T Defives J Dubousset (2005) ArticleTitleAnatomical study of the paraspinal approach to the lumbar Spine 14 366–371 Occurrence Handle10.1007/s00586-004-0802-5
LL Wiltse CW Spencer (1988) ArticleTitleNew uses and refinements of the paraspinal approach to the lumbar spine Spine 13 696–707 Occurrence Handle3175760 Occurrence Handle1:STN:280:DyaL1M%2FhvFGksA%3D%3D Occurrence Handle10.1097/00007632-198813060-00019
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Correspondence: PD Dr. Vassilios I. Vougioukas, Neurocenter, Department of Neurosurgery, Albert-Ludwigs-University of Freiburg, Breisacherstrasse 64, 79106 Freiburg im Breisgau, Germany.
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Shah, M., Kaminsky, J. & Vougioukas, V. Minimally invasive removal of an extradural intraradicular lumbar schwannoma. Acta Neurochir (Wien) 150, 691–694 (2008). https://doi.org/10.1007/s00701-008-1607-9
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DOI: https://doi.org/10.1007/s00701-008-1607-9