Clinical Analysis Of Different Surgical Methods For Spinal Epidural Schwannoma

Object:The authors conducted a study to evaluate the clinical characteristics and surgical outcomes in spinal epidural schwannomas patients with tumor capsules surgically kept or not.Method:Forty-one spinal epidural schwannoma patients were analyzed in this study, with 22 undergoing intracapsular enucleation while 19 for extracapsular resection, including 2 patients performed intracapsular enucleation with neuroendoscope technology. There were 19 cervical dumbbell schwannoma,14 thoracic dumbbell schwannoma and 8 lumbar dumbbell schwannoma.We mainly focused on the tumor locations, the process of surgeries and the neurological prognosis assessed according to Improved Japanese Orthopaedic Association Score (iJOA) system.Results:In total group of 41 spinal dumbbell schwannoma patients, the incisal margin of spinal epidural schwannoma is pathologically proved to be normal nerve tissue. During neurological examinations and iJOA scoring, patients who underwent intracapsular enucleation performed significantly better than patients who underwent total removal (p=0.0488). The amount of bleeding during operation also showed great advantages of intracapsular enucleation over capsule sacrificing ways (p=0.0100). There was no differences between two groups in post operation hospitalization duration (p=0.1003).Conclusion:Spinal epidural schwannoma is different from intradural schwannoma. Intracapsular enucleation frequently makes a safer and easier operation with better outcome. Spinal endoscope technology can be an ideal way to achieve intracapsular enucleation.