Departments of Orthopaedic Surgery and Neurosurgery, Shriners Hospitals for Children-Philadelphia, Philadelphia, Pennsylvania.
Division of Intraoperative Neuromonitoring, SpecialtyCare, Brentwood, Tennessee.
JBJS Case Connect. 2020 Apr-Jun;10(2):e0352. doi: 10.2106/JBJS.CC.19.00352.
A 16-year-old girl with lumbar prominence presented to our outpatient clinic complaining of sporadic back pain without paresthesia. Radiographic investigation revealed a 68° left thoracolumbar curve with the apex at L1. Preoperative magnetic resonance imaging identified a mass at T10-11, subsequently confirmed by pathology as a schwannoma. She was treated surgically with resection and posterior spinal fusion in a single-staged procedure under neuromonitoring guidance. Intraoperative improvement in motor evoked potentials after resection informed the decision to perform simultaneous deformity correction.
We discuss the unusual coincidence of a schwannoma with scoliosis and our management algorithm based on operative changes in neuromonitoring.
一名 16 岁女孩因腰椎前凸到我院门诊就诊，主诉间断性背痛，无感觉异常。影像学检查显示左胸腰椎 68°侧凸，顶点位于 L1。术前磁共振成像（MRI）在 T10-11 发现一肿块，经病理证实为神经鞘瘤。在神经监测引导下，行单一阶段的切除和后路脊柱融合术进行治疗。切除后运动诱发电位的改善提示我们决定同时进行畸形矫正。
我们讨论了神经鞘瘤合并脊柱侧凸的罕见巧合，并根据术中神经监测的变化讨论了我们的治疗方案。
