Therapeutic effect of microsurgical treatment of schwannoma in the spinal canal
CHENG Cheng1, SHANG Aijia2, TANG Hong1, WANG Shejun1, DU Changsheng1, WANG Jianzhen1
1.Department of Neurotumor Surgery, General Hospital of Chinese People’s Armed Police Force, Beijing 100039, China; 2. Department of Neurosurgery, General Hospital of Chinese PLA, Beijing 100853, China
Abstract：Objective To summarize the clinical features of and microsurgical experience from fifty-six cases of schwannoma in the spinal canal.Methods The clinical data of fifty-six patients with neurilemmoma confirmed by pathology between June 2014 and June 2016 was retrospectively analyzed. All the patients in this group received surgery in one phase, twelve of whom were treated by semi-laminae and forty-four by the total laminar approach. Conventional laminae were used for resetting while titanium nails and plates were used for fixation. Three of the cases underwent screw-rod system fixation and fusion. Post-treatment pain, VAS(Visual Analogue Scale), areas of sensory disturbances, limb sensory and motor function scores of ASIA(American Spinal Injury Association)were observed.Results Fifty-five of these cases received total resection, and one case underwent near total resection. Postoperative pathology confirmed malignant schwannoma. Follow-up time ranged from 6 to 24 months with an average of 20.15 months. In forty-nine of these cases, there was significant improvement of postoperative pain, and the VAS decreased from 7.92±1.03 before surgery to 3.25±1.12 at 6 months after surgery (P<0.05). The area of postoperative sensory disturbances increased in eleven cases. The sensory score of ASIA decreased from 225.31±2.53 to 213.76±1.76 (P<0.05) at 6 months after operation. The motor function of ASIA improved in twenty-five cases. ASIA motor score increased from 93.46±1.58 preoperatively to 96.02±1.29 at postoperative 6 months (P<0.05). Reexamination via enhanced MRI showed that tumor recurred in patients with malignant schwannomas and a second surgery was conducted. There was no recurrence in other cases and no secondary kyphosis deformity occurred.Conclusions The personalized microsurgical approach to schwannomas in the spinal canal is highly effective.
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2018, Vol. 29 
