Clinical Features And Surgical Treatment Of Sacral Schwannomas

Objective:Sacral schwannoma is rare,and it is rarely reported in the literature.There are few studies on the diagnosis and treatment of sacral schwannomas.Because of the special anatomy of the sacrum and the characteristics of the schwannomas,there are still challenges the diagnosis and treatment of the sacral schwannomas.To provide clinical basis for the diagnosis and treatment of sacral schwannomas,we explored the clinical features and surgical methods of sacral schwannomas.Methods:From December 2012 to March 2016,retrospective analysis was performed on the medical records of 10 patients with sacral schwannomas who had undergone surgical treatment and had complete follow-up data.The routine examination of X-ray,CT and MR was performed before surgery.and other imaging data.Results:There were 1 male and 9 female patients,with a ratio of 1:9(male vs female).The age ranges from 31 to 63 years old,with an average age of 48 years.Low back pain occurred in 3 patients at the time of treatment,and 7 patients did not complain of special discomfort.The average intraoperative blood loss was 980 ml(range from 100 to 2,000 ml).Six patients underwent preoperative biopsy.Seven patients underwent posterior surgery,two patients underwent combined anterior and posterior surgery,and one patient underwent anterior surgery.All tumors were completely removed after surgery.Postoperative complications occurred in three patients,including two cases of urinary dysfunction,and one case of cerebrospinal fluid leakage and secondary intracranial infection.The average follow-up time was 22.7 months(range from 8 to 44 months).All patients with preoperative symptoms had improved at the final follow-up.Conclusion:The sacral schwannomas are mostly benign tumors.Due to the large space of the sacrum,the tumors often exist for a long time and can grow to a larger volume.The imaging findings are benign tumors.The MRI examination is typically performed on T2-weighted images,with a well-defined borderline and confounding signals.Preoperative CT-guided biopsy was performed to confirm the diagnosis in patients with doubt.Intralesional resection is an important operation for the treatment of sacral schwannomas.Anterior,posterior,or both anterior and posterior approaches are used to preserve nerve function.The prognosis of our patients is good.