Microsurgical resection of giant T11/T12 conus cauda equina schwannoma
In this video, we highlight the anatomy involved with microsurgical resection of a giant T11/T12 conus cauda equina schwannoma. Spinal schwannoma remains the third most common intradural spinal tumor. Tumors undergoing gross total resection usually do not recur. To our knowledge, this is the first...
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| Format: | Article |
| Language: | English |
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Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina
2021-08-01
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| Series: | Biomolecules & Biomedicine |
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| Online Access: | https://www.bjbms.org/ojs/index.php/bjbms/article/view/5153 |
| _version_ | 1797261315846176768 |
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| author | Alisa Arnautovic Mirza Pojskic Kenan Arnautovic |
| author_facet | Alisa Arnautovic Mirza Pojskic Kenan Arnautovic |
| author_sort | Alisa Arnautovic |
| collection | DOAJ |
| description |
In this video, we highlight the anatomy involved with microsurgical resection of a giant T11/T12 conus cauda equina schwannoma. Spinal schwannoma remains the third most common intradural spinal tumor. Tumors undergoing gross total resection usually do not recur. To our knowledge, this is the first video case report of giant cauda equina schwannoma resection. A 55-year-old female presented with paraparesis and urinary retention. Lumbar spine MRI revealed a contrast-enhancing intradural extramedullary tumor at the T11/T12 level. Surgery was performed in the prone position with intraoperative neurophysiology monitoring (somatosensory and motor evoked potentials—SSEPs and MEPs). T11/T12 laminectomies were performed. After opening the dura and arachnoid, the tumor was found covered with cauda equina nerve roots. We delineated the inferior pole of the tumor, followed by opening of the capsule and debulking the tumor. Subsequently, the cranial pole was dissected from the corresponding cauda equina nerve roots. Finally, the tumor nerve origin was identified and divided after nerve stimulation confirmed the tumor arose from a sensory nerve root. The tumor was removed; histological analysis revealed a schwannoma (WHO Grade I). Postoperative MRI revealed complete resection. The patient fully recovered her neurological function. This case highlights the importance of careful microsurgical technique and gross total resection of the tumor in the view of favorable postoperative neurological recovery of the patient. Intraoperative use of ultrasound is helpful to delineate preoperatively tumor extension and confirm postoperative tumor resection.
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| first_indexed | 2024-04-24T23:39:16Z |
| format | Article |
| id | doaj.art-b60d365ed6e04cf3bc7cbfd9c4d15800 |
| institution | Directory Open Access Journal |
| issn | 2831-0896 2831-090X |
| language | English |
| last_indexed | 2024-04-24T23:39:16Z |
| publishDate | 2021-08-01 |
| publisher | Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina |
| record_format | Article |
| series | Biomolecules & Biomedicine |
| spelling | doaj.art-b60d365ed6e04cf3bc7cbfd9c4d158002024-03-15T13:44:12ZengAssociation of Basic Medical Sciences of Federation of Bosnia and HerzegovinaBiomolecules & Biomedicine2831-08962831-090X2021-08-0121410.17305/bjbms.2020.5153Microsurgical resection of giant T11/T12 conus cauda equina schwannomaAlisa Arnautovic0https://orcid.org/0000-0002-1900-1164Mirza Pojskic1https://orcid.org/0000-0002-6123-5589Kenan Arnautovic2https://orcid.org/0000-0003-3745-288XGeorge Washington University School of Medicine, Washington, DC, United StatesDepartment of Neurosurgery, University of Marburg, Marburg, Germany; Medicinski fakultet Osijek, Sveučilište Josip Juraj Strossmayer, Osijek, CroatiaSemmes Murphey Neurologic & Spine Institute, Memphis, TN, United States; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States In this video, we highlight the anatomy involved with microsurgical resection of a giant T11/T12 conus cauda equina schwannoma. Spinal schwannoma remains the third most common intradural spinal tumor. Tumors undergoing gross total resection usually do not recur. To our knowledge, this is the first video case report of giant cauda equina schwannoma resection. A 55-year-old female presented with paraparesis and urinary retention. Lumbar spine MRI revealed a contrast-enhancing intradural extramedullary tumor at the T11/T12 level. Surgery was performed in the prone position with intraoperative neurophysiology monitoring (somatosensory and motor evoked potentials—SSEPs and MEPs). T11/T12 laminectomies were performed. After opening the dura and arachnoid, the tumor was found covered with cauda equina nerve roots. We delineated the inferior pole of the tumor, followed by opening of the capsule and debulking the tumor. Subsequently, the cranial pole was dissected from the corresponding cauda equina nerve roots. Finally, the tumor nerve origin was identified and divided after nerve stimulation confirmed the tumor arose from a sensory nerve root. The tumor was removed; histological analysis revealed a schwannoma (WHO Grade I). Postoperative MRI revealed complete resection. The patient fully recovered her neurological function. This case highlights the importance of careful microsurgical technique and gross total resection of the tumor in the view of favorable postoperative neurological recovery of the patient. Intraoperative use of ultrasound is helpful to delineate preoperatively tumor extension and confirm postoperative tumor resection. https://www.bjbms.org/ojs/index.php/bjbms/article/view/5153schwannomaconuscauda equinamicrosurgerygross total resection |
| spellingShingle | Alisa Arnautovic Mirza Pojskic Kenan Arnautovic Microsurgical resection of giant T11/T12 conus cauda equina schwannoma Biomolecules & Biomedicine schwannoma conus cauda equina microsurgery gross total resection |
| title | Microsurgical resection of giant T11/T12 conus cauda equina schwannoma |
| title_full | Microsurgical resection of giant T11/T12 conus cauda equina schwannoma |
| title_fullStr | Microsurgical resection of giant T11/T12 conus cauda equina schwannoma |
| title_full_unstemmed | Microsurgical resection of giant T11/T12 conus cauda equina schwannoma |
| title_short | Microsurgical resection of giant T11/T12 conus cauda equina schwannoma |
| title_sort | microsurgical resection of giant t11 t12 conus cauda equina schwannoma |
| topic | schwannoma conus cauda equina microsurgery gross total resection |
| url | https://www.bjbms.org/ojs/index.php/bjbms/article/view/5153 |
| work_keys_str_mv | AT alisaarnautovic microsurgicalresectionofgiantt11t12conuscaudaequinaschwannoma AT mirzapojskic microsurgicalresectionofgiantt11t12conuscaudaequinaschwannoma AT kenanarnautovic microsurgicalresectionofgiantt11t12conuscaudaequinaschwannoma |