Dekker Simone E, Glenn Chad A, Ostergard Thomas A, Wu Osmond C, Alonso Fernando, Pace Jonathan A, Rothstein Brian D, Ray Abhishek, Bambakidis Nicholas C
Department of Neurological Surgery, Neurological Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Oper Neurosurg. 2019 Feb 1;16(2):274. doi: 10.1093/ons/opy149.
This 3-dimensional operative video illustrates resection of 2 cervical spine schwannomas in a 19-yr-old female with neurofibromatosis type 2. The patient presented with lower extremity hyperreflexity and hypertonicity. Magnetic resonance imaging (MRI) demonstrated 2 contrast-enhancing intradural extramedullary cervical spine lesions causing spinal cord compression at C4 and C5. The patient underwent a posterior cervical laminoplasty with a midline dural opening for tumor resection. Curvilinear spine cord compression is demonstrated in the operative video. After meticulous dissection, the tumors were resected without complication. The dural closure was performed in watertight fashion followed by laminoplasty using osteoplastic titanium miniplates and screws. Postoperative MRI demonstrated gross total resection with excellent decompression of the spinal cord. The postoperative course was uneventful. The natural history of this disease, treatment options, and potential complications are discussed.
这段三维手术视频展示了一名19岁患有2型神经纤维瘤病的女性患者的2例颈椎神经鞘瘤切除术。患者表现为下肢反射亢进和张力亢进。磁共振成像（MRI）显示2个硬膜内髓外颈椎病变，在C4和C5水平导致脊髓受压。患者接受了后路颈椎椎板成形术，经中线硬膜切开进行肿瘤切除。手术视频中展示了脊髓的曲线形受压情况。经过细致的解剖，肿瘤被切除，无并发症发生。硬膜以防水方式缝合，随后使用骨塑性钛微型钢板和螺钉进行椎板成形术。术后MRI显示肿瘤全切且脊髓减压效果良好。术后过程顺利。文中还讨论了该疾病的自然病程、治疗选择和潜在并发症。
