Surgical Principles of Dumbbell-shaped Spinal Nerve Sheath Tumors

Czech version

Authors: L. Hrabálek; V. Novák; M. Vaverka
Authors‘ workplace: Neurochirurgická klinika LF UP a FN v Olomouci
Published in: Cesk Slov Neurol N 2016; 79/112(4): 445-452
Category: Short Communication

Overview

We retrospectively evaluated outcomes of dumbbell-shaped spinal nerve sheath tumors (neurinoma, neurofibroma) surgeries. The study group consisted of 15 patients with the mean age of 43.6 years (22–76 years) and we performed surgery of 17 tumors. We extirpated intraspinal part via posterior approach at first, then extraspinal part using the same incision, or from a second, separated anterolateral incision. Tumor resection was always complete. We performed delayed stabilization in one case. On the basis of our experience and literature review, we aimed to establish essential principles and to develop recommendations for surgical management of these tumors. Surgical management is determined by the patient’s clinical condition, his/her risk of surgical complications, and by the size and location of the extraspinal part and its proximity to critical structures. We recommend unilateral approach with hemilaminectomy and extirpation of intraspinal component of the tumor first. Combined approaches are suitable in cervical and lumbar spine in particular, with respect to thoracic spine, it should only be used in cases of giant tumors with close proximity to anatomical structures.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Key words:
dumbbell-shaped tumor – nerve sheath tumor – neurinoma – neurofibroma – spinal surgery

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Article was published in

Czech and Slovak Neurology and Neurosurgery

2016 Issue 4