Resection of a Lumbar Intradural Extramedullary Schwannoma: 2-Dimensional Operative Video : Operative Neurosurgery

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Resection of a Lumbar Intradural Extramedullary Schwannoma: 2-Dimensional Operative Video

Strong, Michael J MD, PhD, MPH; Yee, Timothy J MD; Khalsa, Siri Sahib S MD; Saadeh, Yamaan S MD; Muhlestein, Whitney E MD; North, Robert Y MD, PhD; Szerlip, Nicholas J MD

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Operative Neurosurgery 21(1):p E38, July 2021. | DOI: 10.1093/ons/opab097
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Abstract

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Funding

This study did not receive any funding or financial support.

Disclosures

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

COMMENT

The authors present a concise summary of the management of a classic spinal pathology, lumbar intradural, extramedullary schwannoma. Review of the pertinent microsurgical techniques and tools used by the authors is of value to any surgeon who may encounter such pathology.

The use of adjunctive tools, such as ultrasound and neurostimulation, demonstrates the multi-faceted approach a spine surgeon utilizes to safely and effectively resect these lesions. Ultrasound improved spatial orientation to the lesion, assisting the authors in deciding to debulk prior to full circumferential dissection. The integrated, intraoperative decision-making in this video highlights current best practices.

Fortunately, the patient's presenting symptoms were sensory in nature and the associated nerve root did not convey motor function on neuromonitoring. The location of this lumbar intradural, extramedullary schwannoma and surgical acumen demonstrated in the video led to a great clinical outcome in early follow-up.

Niall Buckley

Amgad Hanna

Madison, Wisconsin, USA

Keywords:

Schwannoma; Lumbar laminectomy; Intradural; Extramedullary; Spinal tumor

© Congress of Neurological Surgeons 2021.