TY - JOUR
T1 - Extended lateral parascapular approach for resection of a giant multi-compartment thoracic schwannoma
AU - Vecil, Giacomo G.
AU - McCutcheon, Ian E.
AU - Mendel, Ehud
PY - 2008/12/1
Y1 - 2008/12/1
N2 - Background: Resection of giant thoracic schwannomas is challenging and usually requires a staged approach. The resection of the intraspinal component, usually via laminectomy, is done in one sitting and the intrathoracic component, via thoracotomy, follows at another. We describe the complete resection of a massive multi-compartmental thoracic schwannoma by an extended lateral parascapular approach. Method and findings: The tumor, which presented with local pain and scapular displacement, had intrathoracic paraspinal (10 × 5 × 4 cm), posterolateral upper thoracic paramuscular (19 × 7 × 4 cm), foraminal, and epidural components. It was removed at a single sitting, via a posterior extended lateral parascapular approach that did not require staged procedures, multiple incisions, or repositioning of the patient. This operation included resection of the thoracic, foraminal, and intraspinal components and posterior stabilization with pedicle screws and rods. There were no postoperative neurological complications. Conclusions: The extended lateral parascapular approach allows complete resection of giant multi-compartment schwannomas of the thoracic spine that extend from the canal into the thoracic cavity. It also permits posterior stabilization through the same incision used for tumor removal.
AB - Background: Resection of giant thoracic schwannomas is challenging and usually requires a staged approach. The resection of the intraspinal component, usually via laminectomy, is done in one sitting and the intrathoracic component, via thoracotomy, follows at another. We describe the complete resection of a massive multi-compartmental thoracic schwannoma by an extended lateral parascapular approach. Method and findings: The tumor, which presented with local pain and scapular displacement, had intrathoracic paraspinal (10 × 5 × 4 cm), posterolateral upper thoracic paramuscular (19 × 7 × 4 cm), foraminal, and epidural components. It was removed at a single sitting, via a posterior extended lateral parascapular approach that did not require staged procedures, multiple incisions, or repositioning of the patient. This operation included resection of the thoracic, foraminal, and intraspinal components and posterior stabilization with pedicle screws and rods. There were no postoperative neurological complications. Conclusions: The extended lateral parascapular approach allows complete resection of giant multi-compartment schwannomas of the thoracic spine that extend from the canal into the thoracic cavity. It also permits posterior stabilization through the same incision used for tumor removal.
KW - Dumbbell tumor
KW - Giant schwannoma
KW - Posterior approach
KW - Posterior mediastinal mass
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U2 - 10.1007/s00701-008-0154-8
DO - 10.1007/s00701-008-0154-8
M3 - Article
C2 - 19015809
AN - SCOPUS:57349181450
VL - 150
SP - 1295
EP - 1300
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
SN - 0001-6268
IS - 12
ER -