Celli Paolo, Trillò Giuseppe, Ferrante Luigi
Division of Neurosurgery, St. Andrea Hospital, Department of Neurological Sciences, Second Faculty of Medicine, La Sapienza University Medical School, Rome, Italy.
J Neurosurg Spine. 2005 Jul;3(1):1-11. doi: 10.3171/spi.2005.3.1.0001.
The purpose of this study was to analyze the clinical profile of patients harboring extrathecal and intraradicular nerve sheath tumors (NSTs), located inside the sleeve of an extrathecal nerve root and very often within the proximal portion of the spinal nerve, and to evaluate the incidence of long-term dysfunction of the tumor-affected roots if resected. These tumors have not received particular attention in the literature.
A single-institution series of 16 patients who had undergone surgery for intraradicular NSTs during a 50-year period was selected retrospectively. Data pertaining to clinical features, tumor characteristics, and results of surgery were analyzed.
Extrathecal and intraradicular neurofibromas or schwannomas more frequently affect the lumbar and S-1 nerve roots, often producing root pain only. Selective en bloc enucleation sparing at least part of the motor rootlets is possible for small schwannomas of the extrathecal-preganglion segment of the radix, whereas total resection of the affected root is generally required for radical removal of neurofibromas and large schwannomas. In the authors' experience, neither deafferentation pain nor severe radicular weakness occurs after division of the nerve root harboring the tumor.
本研究旨在分析鞘外及神经根内神经鞘瘤（NSTs）患者的临床特征，这些肿瘤位于鞘外神经根鞘内，且常位于脊神经近端部分，并评估切除受肿瘤影响的神经根后长期功能障碍的发生率。这些肿瘤在文献中未受到特别关注。
回顾性选取一家机构在50年间接受神经根内神经鞘瘤手术的16例患者。分析临床特征、肿瘤特征及手术结果相关数据。
鞘外及神经根内神经纤维瘤或神经鞘瘤更常累及腰神经根和S-1神经根，通常仅产生神经根性疼痛。对于神经根鞘外节前段的小神经鞘瘤，可行选择性整块摘除术，至少保留部分运动神经根丝，而对于神经纤维瘤和大神经鞘瘤的根治性切除，通常需要完全切除受影响的神经根。根据作者的经验，切断含有肿瘤的神经根后，既不会出现去传入性疼痛，也不会出现严重的神经根性无力。
