Abstract：
BACKGROUND:Giant invasive spinal schwannomas (GISSs) comprise a rare, specific subtype of schwannomas that extend >2 spinal levels, erode vertebral bodies, and invade extraspinal tissues. Optimal surgical management of resulting spinal instability has yet to be determined, and overall there is limited published literature on GISS. We report an innovative method used to treat a rare case of lumbosacral GISS using a triangular frame reconstruction to reconnect the spinal column to the pelvis after tumor debulking. This method of using femur allograft in lieu of metal rods can promote stronger bony fusion of the construct. CASE DESCRIPTION:A 19-year-old woman presented with worsening lower back pain, which was due to a giant invasive spinal schwannoma that invaded the L4-S1 vertebral bodies and extended intrathecally from T10-S2, compromising the stability of her spine. The primary resection of the tumor was completed in 3 stages and was followed by a multilevel fusion involving a triangular construct made of femur allograft to reconnect the unstable spinal column with the pelvis. Maximal resection of the tumor was achieved with early rehabilitation. Pseudoarthrosis occurred, which was successfully fused after revision with the addition of an implanted bone stimulator. Seven years later, she remains in stable neurological condition. CONCLUSIONS:We recommend the use of femur allograft in triangular frame constructs for lumbosacral GISS to foster more stable, physiologic spinopelvic fusion.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Paulo D,Semonche A,Tyagi Rdoi
10.1016/j.wneu.2018.02.146subject
Has Abstractpub_date
2018-06-01 00:00:00pages
13-21eissn
1878-8750issn
1878-8769pii
S1878-8750(18)30419-4journal_volume
114pub_type
杂志文章,评审abstract：OBJECTIVE:Although syringomyelia associated with extensive spinal adhesive arachnoiditis (SAA) can be a progressive disease that has potentially devastating clinical consequences, its surgical resolution has remained poorly defined. The aim of the present study was to verify the safety and efficacy of syringoperitoneal...
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pub_type： 杂志文章,评审
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pub_type： 杂志文章
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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pub_type： 杂志文章
doi：10.1016/j.wneu.2016.04.069
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journal_title：World neurosurgery
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pub_type： 历史文章,杂志文章,评审
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更新日期：2018-01-01 00:00:00
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更新日期：2020-11-01 00:00:00
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更新日期：2018-03-01 00:00:00
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更新日期：2017-12-01 00:00:00
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更新日期：2019-06-01 00:00:00
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更新日期：2015-09-01 00:00:00
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pub_type： 杂志文章,评审
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更新日期：2016-07-01 00:00:00
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更新日期：2016-12-01 00:00:00
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更新日期：2015-05-01 00:00:00
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更新日期：2020-06-01 00:00:00
