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Less invasive approaches for the treatment of cervical schwannomas: our experience

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Abstract

Purpose

The purpose of our paper is to illustrate our experience with minimally invasive approaches for the treatment of cervical schwannomas. Moreover, a brief review of the literature was conducted.

Methods

All data regarding patients treated for cervical schwannomas were retrospectively revised. Site, size and extension of the lesions and preoperative neurological status were obtained through re-examination of neuroimaging and clinical records. Postoperative clinical examinations and radiological images were available for all patients. The clinical course was documented using the visual analog scale (VAS), Karnofsky score (KPS) and the Klekamp–Samii score system.

Results

Sixteen patients harboring cervical schwannomas were treated from 2003 to 2009. Hemilaminectomy was performed in eight cases, subtotal hemilaminectomy in four cases, interlaminar fenestration in two cases, osteoplastic hemilaminotomy and laminoplasty in one case each. Postoperative neuroimaging revealed complete removal of the lesion and no signs of spinal instability. At discharge, neurological improvement was observed in 14 patients and all patients demonstrated reduction of VAS score and improvement of KPS and Klekamp–Samii’s score.

Conclusions

Minimal access procedures are increasingly gaining popularity but their use is poorly described in the treatment of cervical tumors. Less invasive approaches may effectively be used instead of traditional laminectomy in the treatment of cervical tumors, especially schwannomas, providing less iatrogenic traumatism and preventing postsurgical spinal instability. Modern neuroimaging allows adequate preoperative planning and microsurgical techniques provide adequate execution of the surgical act. The procedure has to be tailored case by case considering the specific lesional features and the individual anatomical situation.

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Conflict of interest

The author warrants that her contribution is original and that the research is valid and it is not influenced by a secondary interest, such as financial gain. The author discloses all financial relationships that might bias their work. Potential conflicts do not exist.

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Authors and Affiliations

  1. Department of Surgical Sciences (Neurosurgery), University of L’Aquila, L’Aquila, Italy

    S. Raysi Dehcordi, F. Di Cola & R. J. Galzio

  2. Operative Unit of Neurosurgery, San Salvatore Hospital, L’Aquila, Italy

    S. Marzi, A. Ricci & R. J. Galzio

Authors
  1. S. Raysi Dehcordi
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  2. S. Marzi
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  3. A. Ricci
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  4. F. Di Cola
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  5. R. J. Galzio
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Correspondence to S. Raysi Dehcordi.

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Dehcordi, S.R., Marzi, S., Ricci, A. et al. Less invasive approaches for the treatment of cervical schwannomas: our experience. Eur Spine J 21, 887–896 (2012). https://doi.org/10.1007/s00586-011-2118-6

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  • DOI: https://doi.org/10.1007/s00586-011-2118-6

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