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Extrathecal intraradicular nerve sheath tumor
Paolo Celli1, Giuseppe Trillò, Luigi Ferrante
1Division of Neurosurgery, St. Andrea Hospital, Department of Neurological Sciences, Second Faculty of Medicine, La Sapienza University Medical School, Rome, Italy. Paolo.Celli@uniroma1.it
Journal of Neurosurgery. Spine
|August 27, 2005
Summary
Extrathecal and intraradicular nerve sheath tumors (NSTs) commonly affect lumbar and S-1 nerve roots, often causing only pain. Surgical resection of these spinal nerve tumors is feasible, with minimal long-term radicular dysfunction reported.
Area of Science:
- Neurosurgery
- Spinal Oncology
- Nerve Sheath Tumors
Background:
- Extrathecal and intraradicular nerve sheath tumors (NSTs) are rare spinal neoplasms.
- These tumors, often neurofibromas or schwannomas, arise within the nerve root sleeve.
- Limited literature exists on their clinical presentation and surgical outcomes.
Purpose of the Study:
- To analyze the clinical profile of patients with extrathecal and intraradicular NSTs.
- To evaluate the incidence of long-term dysfunction after resection of tumor-affected nerve roots.
Main Methods:
- Retrospective analysis of a single-institution series of 16 patients.
- Patients underwent surgery for intraradicular NSTs over a 50-year period.
- Data collected included clinical features, tumor characteristics, and surgical outcomes.
Main Results:
- Lumbar and S-1 nerve roots are most frequently affected by these NSTs.
- Root pain is the predominant symptom.
- Small schwannomas allow for selective en bloc enucleation, while larger tumors and neurofibromas often require total root resection.
Conclusions:
- Extrathecal and intraradicular NSTs primarily impact lumbar and S-1 nerve roots, often presenting with isolated root pain.
- Surgical management is feasible, with selective or total resection depending on tumor type and size.
- Division of the affected nerve root does not appear to cause significant deafferentation pain or severe radicular weakness.