Agrawal Amit, Cincu Rafael, Wani Bhushan
Department of Neurosurgery, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India.
Acta Orthop Traumatol Turc. 2009;43(6):535-9. doi: 10.3944/AOTT.2009.535.
We report on an uncommon type of complex dumbbell schwannoma involving the thoracolumbar region, which was successfully managed with unilateral hemilaminectomy using a modified posterior approach. A 19-year-old male patient presented with one-year history of low back pain radiating to the lower limbs, limping of two month-history, and hesitancy of micturition of 15-day duration. Clinically, a diagnosis of conus-cauda lesion was suspected. Findings of the X-ray and magnetic resonance imaging of the dorsolumbar spine were suggestive of a complex dumbbell schwannoma, extending from the lower part of the T11 level to the upper part of the L1 vertebrae left to the spinal cord, with extension through the intervertebral foramina to the paraspinal region on the left side. A modified posterior approach with unilateral laminectomy was used for complete removal of the tumor. The histological diagnosis was schwannoma. The patient had minimal pain postoperatively, he was mobilized on the third day without the need for any external support. At one year follow-up, he had normal motor and sensory functions in the lower limbs.
我们报告了一例累及胸腰段的罕见类型的复杂哑铃形神经鞘瘤，采用改良后路单侧半椎板切除术成功治疗。一名19岁男性患者，有一年的下腰痛并向下肢放射的病史，两个月的跛行病史，以及持续15天的排尿踌躇。临床上，怀疑为圆锥马尾病变。胸腰椎X线和磁共振成像结果提示为复杂哑铃形神经鞘瘤，从T11水平下部延伸至L1椎体上部，位于脊髓左侧，并通过椎间孔延伸至左侧椎旁区域。采用改良后路单侧椎板切除术完整切除肿瘤。组织学诊断为神经鞘瘤。患者术后疼痛轻微，术后第三天即可活动，无需任何外部支撑。随访一年时，其下肢运动和感觉功能正常。
