Treatment results in the differential surgery of intradural extramedullary schwannoma of 110 cases.

Study designA retrospective study of intradural extramedullary schwannoma.ObjectiveThe purpose of this study was to compare treatment results in the differential surgery of intradural extramedullary schwannoma.BackgroundA reference guide to the surgical procedures available to treat intradural extramedullary schwannoma has not yet been established.MethodsThe study retrospectively reviewed 110 patients: Group A: laminectomy+microscopic excision; Group B: hemilaminectomy+microscopic excision; Group C: laminectomy+microscopic excision+pedicle screw fixation. Researchers selected patients for this retrospective review by applying the following criteria: 1) back pain spread out from the tumor level, sensory and motor loss; 2) treatment by surgery; 3) clinical diagnosis made by physical examination, magnetic resonance imaging (MRI), and pathology; 4) a minimum clinical and radiologic follow-up of 12 months. The clinical outcomes were assessed by comparing the Visual Analogue Pain Scores (VAS) and the Japanese Orthopedic Association Scores (JOA score). The study also performed a cost-effectiveness analysis.ResultsCervical vertebrae: The estimated blood loss in Group B was significantly less than in Group C (PConclusionIn the case of appropriate surgical indications, the study suggests that hemilaminectomy+microscopic excision is advantageous in the removal of cervical schwannoma, and that laminectomy+microscopic excision is advantageous in the removal of thoracic schwannoma; lumbar intradural extramedullary schwannoma can be managed by laminectomy+microscopic excision+pedicle screw fixation.