Surgical management of schwannomas in the craniocervical junction region

Abstract

Objective To investigate the clinical characteristics and surgical management of schwannomas in the craniocervical junction region. Methods Clinical data of 29 patients with craniocervical schwannomas was retrospectively studied. According to MRI examination, tumors in 3 cases were located in anterolateral region of the spinal cord and tumors in 26 patients were located in posterolateral side of the spinal cord. Among the 29 patients, 4 patients had intra- and extra- spinal schwannomas. All the tumors were excised through posterior approach. The extent of bone window was to the lateral side of the spinal cord. If spinal stability was destroyed by osteotomy intraoperatively or by bone erosion of the tumor preoperatively, internal fixation of occipitocervical fusion was performed after tumor excision. Results Total resection was achieved in all of the 29 patients, and postoperative pathological result was schwannoma. The pain of the back of neck and occipital region was relieved after operation and numbness of neck and occipital region in 13 patients disappeared in the follow-up of 3 months. There was no new neurological defect, no cerebrospinal fluid fistula and no dead patient. During the follow-up period of 3-24 months, there was no tumor recurrence and no spinal spondylolisthesis or deformity. Conclusion Total resection of tumor can be achieved by posterior approach for schwannomas in the craniocervical region. If spinal stability was destroyed by the tumor, internal fixation will be performed. doi：10.3969/j.issn.1672-6731.2013.11.005 Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v13n11a5