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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 v...

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Autores principales: Arnautovic, Alisa, Pojskic, Mirza, Arnautovic, Kenan I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292862/
https://www.ncbi.nlm.nih.gov/pubmed/33052079
http://dx.doi.org/10.17305/bjbms.2020.5153
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author Arnautovic, Alisa
Pojskic, Mirza
Arnautovic, Kenan I.
author_facet Arnautovic, Alisa
Pojskic, Mirza
Arnautovic, Kenan I.
author_sort Arnautovic, Alisa
collection PubMed
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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spelling pubmed-82928622021-08-01 Microsurgical resection of giant T11/T12 conus cauda equina schwannoma Arnautovic, Alisa Pojskic, Mirza Arnautovic, Kenan I. Bosn J Basic Med Sci Video Article 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. Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina 2021-08 /pmc/articles/PMC8292862/ /pubmed/33052079 http://dx.doi.org/10.17305/bjbms.2020.5153 Text en Copyright: © The Author(s) (2020) https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License
spellingShingle Video Article
Arnautovic, Alisa
Pojskic, Mirza
Arnautovic, Kenan I.
Microsurgical resection of giant T11/T12 conus cauda equina schwannoma
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 Video Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292862/
https://www.ncbi.nlm.nih.gov/pubmed/33052079
http://dx.doi.org/10.17305/bjbms.2020.5153
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