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Surgical management of sacral schwannomas: a 21-year mayo clinic experience and comparative literature analysis

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Abstract

Introduction

Sacral and presacral schwannomas are rare, accounting for a minority of spinal schwannomas. We present our institution’s experience surgically treating spinal schwannomas and compare it to the literature.

Methods

Data were collected for 27 patients treated surgically for sacral or presacral schwannoma between 1997 and 2018 at all Mayo Clinic locations and 93 patients in the literature. Kaplan–Meier disease-free survival analysis was conducted. Unpaired two-sample t tests and Fisher’s exact tests assessed statistical significance between groups.

Results

Our patients and those in the literature experienced a similar age at diagnosis (49.9 y/o. vs 43.4 y/o., respectively). Most of our patients (59.3%) reported full recovery from symptoms, while a minority reported partial recovery (33.3%) and no recovery (11.1%). A smaller percentage in the literature experienced full recovery (31.9%) and partial recovery (29.8%) but also no recovery (1.1%). Our patients experienced fewer complications (14.8% versus 25.5%). Disease-free survival curves for all patients showed no significant variation in progression by extent of resection of schwannoma (log-rank P = 0.26). No lesion progression was associated with full or partial symptom improvement (p = 0.044), and female patients were more likely to undergo resection via a posterior approach (p = 0.042).

Conclusion

Outcomes of patients with sacral or presacral schwannomas vary based on patient demographics, tumor characteristics, symptoms, and surgical treatment. Among the range of symptoms experienced by these patients, the most common is pain. Prognosis improves and overall survival is high when the surgical approach towards sacral schwannomas is prepared and executed appropriately.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA

    William Mualem, Abdul-Karim Ghaith, Deja Rush, Ryan Jarrah, Yohan Alexander, Cameron Zamanian & Mohamad Bydon

  2. Department of Neurologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    William Mualem, Abdul-Karim Ghaith, Deja Rush, Ryan Jarrah, Yohan Alexander, Cameron Zamanian, John L. D. Atkinson, William E. Krauss, Robert J. Spinner & Mohamad Bydon

  3. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Michael J. Yaszemski

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  1. William Mualem
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All authors contributed to writing and editing of the manuscript.

Corresponding author

Correspondence to Mohamad Bydon.

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The authors have no relevant financial or non-financial interests to disclose.

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Mayo Clinic IRB: 21-000125.

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No consent needed due to the retrospective nature of our study and the use of patient records.

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Supplementary Information

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11060_2022_3986_MOESM1_ESM.jpg

Supplementary file1 (JPG 25 kb) Fig. 1 Kaplan–Meier curve demonstrating disease-free survival as per extent surgical resection of spinal schwannoma in patients at our institution and those in the literature. Log-rank P = 0.26

11060_2022_3986_MOESM2_ESM.jpg

Supplementary file2 (JPG 24 kb) Fig. 2 Kaplan–Meier curve demonstrating disease-free survival of patients as per extent of surgical resection of spinal schwannoma in patients in the literature. Log rank P = 0.17

Supplementary file3 (DOCX 44 kb)

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Mualem, W., Ghaith, AK., Rush, D. et al. Surgical management of sacral schwannomas: a 21-year mayo clinic experience and comparative literature analysis. J Neurooncol 159, 1–14 (2022). https://doi.org/10.1007/s11060-022-03986-w

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