Combined treatment “microsurgery-arthrodesis”: total resection of dorsal schwannoma plus dorsal arthrodesis

Abstract

Introduction: Schwannomas are benign, unusual, and slow-growing tumors originating in Schwann cells, they constitute 30% of spinal tumors and are more common in women between the fifth and sixth decade. The symptoms depend on the location, degree of spinal cord compression, vertebral erosion, and tumor size. The diagnosis is clinical and imaging. The gold standard of treatment is total excision, to avoid recurrence. Surgical planning must be holistic, and the surgical field must be wide to allow complete excision. Clinical case: A 65-year-old woman with symptoms of axial pain, with an imaging diagnosis of a spinal tumor, is presented. Total resection of the tumor was performed by means of a hemilaminectomy plus dorsal arthrodesis. The pathology result was spinal schwannoma. The patient evolved favorably without presenting a neurological deficit. Conclusion: Hemilaminectomy plus posterior arthrodesis with facetectomy constitutes an effective way for total resection of extramedullary intradural tumors at the dorsal level, as was the case we performed in our patient. This allows for a larger operating field and optimizes the surgical approach. Keywords: Spinal Cord Neoplasms, Neurilemmoma, Laminectomy, Arthrodesis. (Source: MeSH NLM)