Analysis of the resection of spinal schwannomas. Experience in a single institution

Abstract

Introduction: Spinal Schwannomas are benign tumors that comprehend 25% from those affecting intradural spinal tumors. In general, after surgical intervention they have an excellent response. The major dilema during surgery is choosing between complete resection, which entails the risk of sacrificing the entire nerve root, or subtotal removal of the lesion with high probability of recurrence. Objective: Here we reported our experience with 27 cases of spinal schwannomas, by means of identification and analysis of variables showing better surgical outcomes. Material and methods: Between 2009 and 2015, 27 clinical files of spinal schannomas were revised retrospectevely. Results: 27 cases were analyzed (13 women and 14 men). The mean age was of 36.8 years old (17-58y). Cervical location was present in 11 patients (40.7%), toracic in 11 patients (40.7%), and lumbar in 5 patients (18.5%). The most predominant clinical presentation was referred pain on the spine or radicular type in 16 patients (59.25%) followed by sensory alterations in 7 patients (25.92%) and sphincter dysfunction in 4 patients (14.81%). More common site of allocation was intradural in 11 patients (40.7%), extradural in 8 patients (29.6%), and intra and extradural in 8 patients (29.6%). Twenty five patients (92.59%) showed improvement and without comorbidities. Two patients (7.4%), who were managed with subtotal resection, developed recurrence of the tumor 3 year later. Conclusions: Total tumor resection can be obtained in almost all intradural and extradural lesions, accomplishing excellent results. Whereas, in those cases were subtotal resection is applied, utterly develop recurrence.