Intramedullary schwannomas: long-term outcomes of ten operated cases

Abstract

Intramedullary schwannomas are very rare. Most studies on intramedullary schwannomas have been case reports with literature reviews. This study presented a surgical series of ten patients with histologically proven intramedullary schwannomas. From 1995 to 2010, ten patients (2.7 %) presented with intramedullary schwannomas out of 365 patients with spinal schwannomas. Their clinical and radiological findings and operative records were reviewed. There were 6 female and 4 male patients with a mean age of 45.5 years. The mean follow-up period was 75.7 months. Three tumors were located in the cervical spine and 7 were located in the thoracic spine. Intraoperatively, the tumor was connected with the dorsal rootlet in 4 cases and with the ventral rootlet in 1 case. Gross total resection (GTR) of the tumor with a well-demarcated dissection plane was achieved in 8 cases and subtotal resection (STR) was achieved in 2 cases. The current status of all the patients was improved compared to the preoperative presentation at last follow-up and the symptoms present before the surgery were improved in all the cases at last follow-up. The postoperative follow-up magnetic resonance imaging showed no recurrence in the 8 GTR cases during the follow-up period of 83.5 months on average. No interval change in residual tumors was observed in the 2 STR cases (45- and 55-month follow-up periods). Intramedullary schwannomas are amenable to surgery. It is possible to achieve GTR of intramedullary schwannomas that have a well-demarcated dissection plane. Additionally, a good clinical outcome after GTR can be expected.