More than just sciatica. Clinical presentation, surgical treatment and functional outcomes of sciatic nerve...

Introduction: Peripheral nerve schwannomas are rare benign tumors. The onset of a schwannoma in the sciatic nerve is uncommon and can impair the nerve’s functionality. To this date, the literature on this topic is mainly composed of case reports, lacking large case series. Aim: To overcome the limitations of previous literature, we performed a retrospective study on surgical enucleation of sciatic nerve schwannomas, evaluating surgical treatment’s clinical and functional effectiveness. Materials and methods: We examined retrospectively all cases of sciatic nerve schwannomas that underwent surgical enucleation between 2016 and 2022. For each one, we analyzed lesion size and localization. Motor and sensory deficits, Tinel sign, and lower limb functionality (assessed using MSTS and LEFS score) were evaluated before surgery and at the patients’ latest follow-up. Results: Eight cases were included in our study. All patients had pre-operative sensory deficits. The mean MRC score was 3.9 before surgery, while MSTS and LEFS scores were 21.1 and 59.5, respectively. No local recurrence or major complication were recorded. After surgery, the mean MRC score rose to 5, and both MSTS scores (29.5) and LEFS scores (78.1) significantly increased compared to pre-operative records. Conclusions: In our cohort, good functional performances and symptomatic relief were seen after the removal of sciatic nerve schwannomas. Early diagnosis and prompt surgical treatment should represent the therapeutic approach for sciatic neurinomas, considering the good postoperative outcomes.