scholarly journals Anterior Corpectomy Approach for Removal of a Cervical Intradural Schwannoma

2008 ◽  
Vol 35 (1) ◽  
pp. 106-110 ◽  
Author(s):  
Steven Casha ◽  
Jing Cheng Xie ◽  
R. John Hurlbert
Keyword(s):  
Spinal Cord ◽  
Schwann Cells ◽  
Spinal Canal ◽  
Anterior Approach ◽  
Cervical Spondylosis ◽  
Spinal Reconstruction ◽  
Anterior Corpectomy ◽  
Intradural Extramedullary ◽  
Spinal Schwannoma ◽  
Dentate Ligament

Spinal schwannomas are typically intradural-extramedullary neoplasms thought to arise from Schwann cells or their progenitors which occur proportionally throughout the spinal canal. They most typically arise from dorsal sensory rootlets and occupy a posterior-lateral location in the spinal canal. Thus, posterior surgical procedures have become the conventional method to remove these tumors providing adequate exposure in most cases. More anteriorly located tumors may be approached through a posterolateral direction with section of the dentate ligament and gentle rotation of the spinal cord. However, posterior and posterolateral approaches may be problematic for removing tumors located in the midline and ventral to the spinal cord.Although the anterior approach has been applied widely to treat cervical spondylosis, it has rarely been used to remove intradural tumors. Here, we present a case of a ventral cervical spinal schwannoma removed through an anterior approach followed by spinal reconstruction.

Measures of spinal canal stenosis and relationship to spinal cord structure in patients with cervical spondylosis

2012 ◽  
Vol 39 (4) ◽  
pp. 236-242 ◽  
Author(s):  
P.G. Lindberg ◽  
A. Feydy ◽  
K. Sanchez ◽  
F. Rannou ◽  
M.A. Maier
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Cervical Spondylosis ◽  
Spinal Canal Stenosis ◽  
Canal Stenosis

scholarly journals Conus Medullary Syndrome secondary to Spinal Schwannoma : A report of 3 cases

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Ed Simor Khan Mor Japar Khan ◽  
Nur Akmal Ismail Ismail Mansor ◽  
Mohd Ariff Sharifudin ◽  
Mohd Adham Shah Ayeop ◽  
Chan Kin Hup ◽  
...  
Keyword(s):  
Back Pain ◽  
Schwann Cells ◽  
Nerve Root ◽  
Surgical Excision ◽  
Radicular Pain ◽  
Lower Limbs ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Intradural Extramedullary ◽  
Spinal Schwannoma

Spinal Schwannoma originates from the Schwann cells, hence it is called Schwannoma. The tumor localization is in various parts of the spinal cord, but prevails in cervical and thoracic. In the literature 70 to 80% of spinal schwannomas are reported to be intradural in location, and 15% with both intradural and extradural components. All 3 cases were female in their 4th-5th decade, presented with either low back pain, radiculopathy, weakness of both lower limbs associated with urinary incontinence. MRI revealed a well defined mass adjacent to conus medullary area located intradural, extramedullary. All three patients underwent microscopic assisted excision of the tumour. All patients had Good Early Outcome. Spinal schwannoma causing Conus Medullary Syndrome is rare. Back pain and radicular pain were most common early presenting symptoms while urinary symptoms occur later. Schwannomas typically arise from a single nerve root originating from the schwann cells. To obtain total resection, the affected nerve root is commonly sacrificed in order to prevent recurrence. Intradural Extramedullary Schwannoma, even presented at a later stage with significant neurological deficit, has a Good Outcome post operatively owing to its Benign nature, Extramedullary location, and a Meticulous Microscopic assisted Complete Surgical Excision.

scholarly journals The outcome of surgical resection in complete paraplegia patient due to thoracic schwannoma

2021 ◽  
Vol 4 (2) ◽  
pp. 78-83
Author(s):  
Maria Monica ◽  
Bair Ginting
Keyword(s):  
Spinal Cord ◽  
Daily Activity ◽  
Tumor Resection ◽  
Spinal Tumor ◽  
Sensory Function ◽  
Low Grade ◽  
Spinal Cord Surgery ◽  
Intradural Extramedullary ◽  
Spinal Schwannoma

Spinal schwannoma is the most common benign intradural spinal tumor. However, studies regarding the neurological outcome of tumor resection in complete paraplegia patients are still lacking. The authors report a case of complete paraplegia due to primary intradural extramedullary low-grade schwannoma of the spinal cord. Surgery was performed 5 weeks after the paraplegia complaint first occurred. The patient did not regain motor nor sensory function in the 1-month follow-up but resolution of pain was achieved. The patient was able to perform daily activity more comfortably. In the event of complete paraplegia, surgery should still be offered promptly as it can still benefit the patient. Possible factors that could have influenced the prognosis in our study are discussed.

Cervical myeloradiculopathy caused by arthrotic hypertrophy of the posterior facets and laminae

1978 ◽  
Vol 49 (3) ◽  
pp. 387-392 ◽  
Author(s):  
Joseph A. Epstein ◽  
Bernard S. Epstein ◽  
Leroy S. Lavine ◽  
Robert Carras ◽  
Alan D. Rosenthal
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Anterior Approach ◽  
Nerve Root Compression ◽  
Nerve Roots ◽  
Anatomical Studies ◽  
Content Type ◽  
Significant Pathology ◽  
Cervical Spinal Stenosis ◽  
Fine Print

✓ Five patients with typical cervical myeloradiculopathy caused by focal cervical spinal stenosis are presented. Dorsal intrusions into the spinal canal by hypertrophied apophyseal joints and thickened laminae resulted in cord and nerve root compression. Minor spondylotic changes were present in the floor of the spinal canal. Laminar decompression with foraminotomy and facetectomy relieved the patients of their symptoms. An anterior approach should not be considered in the management of this disorder. Our findings of severe apophyseal arthrosis with lesser degrees of associated spondylosis are similar to those described in anatomical studies by other authors. While uncommon, myelopathy caused by dorsal compression of the spinal cord and nerve roots deserves specific mention so that therapy can be directed to the proper quadrants of the spinal canal wherein the significant pathology is located.

Posterior Approach for a Ventral Intradural Extramedullary Meningioma: 2-Dimensional Operative Video

2020 ◽  
Vol 20 (1) ◽  
pp. E50-E50
Author(s):  
Elena Solli ◽  
Vincent Dodson ◽  
Fareed Jumah ◽  
Nitesh V Patel ◽  
Simon Hanft
Keyword(s):  
Spinal Cord ◽  
Posterior Approach ◽  
Complete Resection ◽  
Surgical Access ◽  
Patient Consent ◽  
Bilateral Approach ◽  
Intradural Extramedullary ◽  
Multiple Levels ◽  
The Right ◽  
Dentate Ligament

Abstract Ventral thoracic meningiomas are rare entities in which the spinal cord is attenuated and draped over the meningioma symmetrically. This is a challenging surgical entity compared to typical intradural meningiomas, which nearly always eccentrically displace the cord. In these more common meningiomas, surgical access is fairly straightforward as the meningioma is often visualized upon opening the meninges. Resection can be more safely performed with the cord largely shifted. In cases of ventral meningioma, the tumor is hidden ventral to the spinal cord, and techniques to safely mobilize the spinal cord must be utilized. We demonstrate that an entirely posterior approach allows complete resection of a ventrally situated mass. After careful identification and sectioning of the dentate ligament at multiple levels on the right side of the canal, we then suture and rotate the dentate ligament at each site, thereby allowing progressive visualization of the ventral meningioma. A narrow, but viable, working corridor to the tumor allows safe debulking. Once it is felt that the tumor can no longer be safely excised through the created corridor, we then disconnect our dentate sutures and move to the other side of the canal. Similarly, the dentate is sectioned and sutured so that the contralateral aspect of the meningioma can be visualized and debulked. The tumor can then be safely removed. A standard posterior approach and midline durotomy allows this bilateral approach to a ventrally situated meningioma and, therefore, in our mind, represents a safe and also highly effective road to resection.  Patient consent was obtained prior to publication.

MODIFIED LAMINOPLASTY AFTER EXCISION OF CERVICAL SCHWANNOMA WITH LARGE EXTRAVERTEBRAL EXTENSION

2018 ◽  
Vol 1 (1) ◽  
pp. 9
Author(s):  
Muhammad Faris ◽  
Abdul Hafid Bajamal ◽  
Zaky Bajamal ◽  
Krisna Tsaniadi Prihastomo
Keyword(s):  
Surgical Treatment ◽  
Spinal Canal ◽  
Conventional Technique ◽  
Modified Technique ◽  
Younger Patients ◽  
Knowing That ◽  
Anteroposterior Diameter ◽  
Intradural Extramedullary ◽  
Intradural Extramedullary Tumour

Tumour excision and laminoplasty are commonly performed as surgical treatment of extra vertebral extension of cervical schwannoma. It is worth knowing that the conventional technique of multilevel laminectomy may hinder younger patients in the long-term. This article reports a 30-year old man with an intradural-extramedullary tumour which extended from C4 to T1 that underwent modified laminoplasty.  This modified technique is preferable in maintaining the anteroposterior diameter of spinal canal as well as reducing the displacement of guttered laminae

A scientific research study on the management of Manyasthamba (Cervical Spondylosis) with Nasya and Nasapana

2019 ◽  
Vol 4 (04) ◽  
Author(s):  
Unnikrishnan V S ◽  
Prashanth A S ◽  
Madhusudan Kulkarni
Keyword(s):  
Spinal Cord ◽  
Clinical Data ◽  
Food Habits ◽  
Cervical Spondylosis ◽  
Research Study ◽  
Weight Bearing ◽  
Scientific Research ◽  
Modern Era ◽  
Treatment Aspect

The science of life Ayurveda, not only deals with the prevention of diseases by maintaining health but also with the alleviation of diseases. In this ultra modern era due to change in lifestyles, sedentary works and food habits, people are unable to follow the Dinacharya and Ritucharya as explained in the classics, which may lead to different diseases. Due to improper postural habits, weight bearing and other unwholesome diets and habits there are higher the chances of discomfort and disease pertaining to spinal cord. Manyasthambha is one such condition that disturbs a big population due to today’s alterations in lifestyle. Here an effort is made to study and understand the role of Nasya Karma, Nasaapana and Shamanaushadhi like Vyoshadi Guggulu in the treatment aspect of this disease. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Manyasthambha. As per the clinical data, ‘Nasaapana is found to be more effective than Nasya Karma’. So it can be concluded that better results can be obtained with Shaddharana Yoga as Amapachana, Nasaapana with Mashabaladi Kwatha followed by Vyoshadi Guggulu as Shamanoushadhi.

scholarly journals Promoting Neuronal Outgrowth Using Ridged Scaffolds Coated with Extracellular Matrix Proteins

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 479
Author(s):  
Ahad M. Siddiqui ◽  
Rosa Brunner ◽  
Gregory M. Harris ◽  
Alan Lee Miller ◽  
Brian E. Waletzki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Extracellular Matrix ◽  
Schwann Cells ◽  
Cell Attachment ◽  
Dorsal Root Ganglion Neurons ◽  
Neurologic Recovery ◽  
Cord Injury ◽  
Biodegradable Hydrogel ◽  
Ganglion Neurons ◽  
Novel Scaffold

Spinal cord injury (SCI) results in cell death, demyelination, and axonal loss. The spinal cord has a limited ability to regenerate, and current clinical therapies for SCI are not effective in helping promote neurologic recovery. We have developed a novel scaffold biomaterial that is fabricated from the biodegradable hydrogel oligo(poly(ethylene glycol)fumarate) (OPF). We have previously shown that positively charged OPF scaffolds (OPF+) in an open spaced, multichannel design can be loaded with Schwann cells to support axonal generation and functional recovery following SCI. We have now developed a hybrid OPF+ biomaterial that increases the surface area available for cell attachment and that contains an aligned microarchitecture and extracellular matrix (ECM) proteins to better support axonal regeneration. OPF+ was fabricated as 0.08 mm thick sheets containing 100 μm high polymer ridges that self-assemble into a spiral shape when hydrated. Laminin, fibronectin, or collagen I coating promoted neuron attachment and axonal outgrowth on the scaffold surface. In addition, the ridges aligned axons in a longitudinal bipolar orientation. Decreasing the space between the ridges increased the number of cells and neurites aligned in the direction of the ridge. Schwann cells seeded on laminin coated OPF+ sheets aligned along the ridges over a 6-day period and could myelinate dorsal root ganglion neurons over 4 weeks. This novel scaffold design, with closer spaced ridges and Schwann cells, is a novel biomaterial construct to promote regeneration after SCI.

scholarly journals Far Lateral Approach for Resection of Transverse Ligament Cyst

2020 ◽  
Author(s):  
Lattimore Madison Michael ◽  
Vincent Nguyen ◽  
Jaafar Basma ◽  
William Mangham ◽  
Nickalus Khan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mass Effect ◽  
Lateral Approach ◽  
Microsurgical Anatomy ◽  
Transverse Ligament ◽  
Far Lateral Approach ◽  
Adequate Understanding ◽  
Far Lateral ◽  
Microsurgical Resection ◽  
Dentate Ligament

Abstract Objectives This study was aimed to describe a far lateral approach for microsurgical resection of a transverse ligament cyst, with emphasis on the microsurgical anatomy and technique. Design A far lateral craniotomy is performed in the lateral decubitus position. After opening the dura laterally, dural sutures are placed for retraction. A stitch placed through the dentate ligament is advantageous to rotate the spinal cord to allow access to the ventral cyst. The cyst is marsupirlized and mass effect on the spinal cord is relieved. Photographs of the region are borrowed from Dr Rhoton's laboratory to illustrate the microsurgical anatomy. Participants The first author performed the surgery and edited the video. Chart review and literature review were performed by the other authors. Outcome Measures Outcome was assessed with postoperative neurological function. Results The patient was discharged home after an uneventful hospital course. At short-term follow-up, the patient had a significant improvement in postoperative strength. Conclusion The far lateral approach provides an adequate corridor to the ventrolateral brainstem in combination with utilization of the dentate ligament to reach ventral cysts compressing the spinal cord. An adequate understanding of the relevant microsurgical anatomy is a key to safe surgery in this region.The link to the video can be found at: https://youtu.be/5MGVPO2Q2pI.

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