Percutaneous Endoscopic Removal of Cervical Foraminal Schwannoma via Interlaminar Approach: A Case Report
| Autor: | Fang Shen, Yongjian Zhu, Ying Yao, Guang-Yu Ying, Chien-Min Chen, Zong-Yang Wu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Percutaneous Vertebral artery Schwannoma 03 medical and health sciences 0302 clinical medicine medicine.artery Humans Medicine Intervertebral foramen Spinal Neoplasms medicine.diagnostic_test business.industry Middle Aged medicine.disease Endoscopic Procedure Endoscopy Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Spinal nerve Neuroendoscopy Cervical Vertebrae Female Surgery Neurology (clinical) Radiology business Neurilemmoma 030217 neurology & neurosurgery Cervical vertebrae |
| Zdroj: | Operative Neurosurgery. 14:1-5 |
| ISSN: | 2332-4260 2332-4252 |
| DOI: | 10.1093/ons/opx088 |
| Popis: | Background and importance Cervical foraminal schwannomas commonly originate from spinal nerves that pass through the intervertebral foramen of the cervical vertebrae. Because of the proximity of this type of tumor to the vertebral artery and spinal nerves, surgical management remains a major challenge. Conventional open spine surgery usually requires the removal of the articular process and is supplemented by a simultaneous posterolateral spine fusion surgery. To decrease the associated risks of surgical complications by further reducing invasiveness, percutaneous spinal endoscopy may be used for resection of foraminal spinal neoplasm. Clinical presentation A 52-yr-old female who presented with neck pains with duration of 1 yr was admitted to our hospital. Physical examination revealed moderate rigidity in the neck and grade 5 muscle strength in both upper and lower limbs. Preoperative magnetic resonance imaging (MRI) scans demonstrated a left-sided lesion at the C3-C4 intervertebral foraminal area. Under C-arm fluoroscopy navigation and neuromonitoring, the endoscope was properly positioned on the same side of the tumor, and a small part of the left C3 inferior and C4 superior lamina were first removed by an endoscopic drill to enlarge the interlaminar space. Next, through an endoscopic working canal, the left intervertebral ligamentum flavum was removed to fully expose the tumor. The tumor mass was finally resected in a piecemeal approach. Postoperative MRI confirmed complete tumor resection. Conclusion This is the first case report of a total removal of a cervical foraminal schwannoma with a percutaneous spinal endoscopic procedure. |
| Databáze: | OpenAIRE |
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