Clinical characteristics and surgical treatment of upper cervical intra-and extraspinal dumbbell-shaped schwannoma
10.3969/j.issn.1004-406X.2025.04.01
- VernacularTitle:上颈椎椎管内外哑铃型神经鞘瘤的临床特点和手术方案
- Author:
Bing TU
1
;
Junlin CHEN
1
;
Miao HU
1
;
Xiangyang MA
1
;
Honglei YI
1
Author Information
1. 中国人民解放军南部战区总医院骨科 510010广州市
- Publication Type:Journal Article
- Keywords:
Upper cervical vertebra;
Dumbbell-shaped schwannoma;
Clinical characteristics;
Operation plan
- From:
Chinese Journal of Spine and Spinal Cord
2025;35(4):337-341
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To analyze the clinical characteristics of upper cervical vertebrae with dumbbell schwannoma,and to explore its clinical symptoms,imaging features,and treatment plans.Methods:A retro-spective analysis was performed on 14 patients with upper cervical intra-and extraspinal dumbbell-shaped schwannoma admitted to the Spinal Surgery Department of Southern Theater General Hospital from January 2022 to June 2024,including 9 males and 5 females,aged 43.64±11.96 years(25-61 years).According to the location,size,scope of the tumor,and relationship with the surrounding important tissue structure in upper cervical spine,the relevant clinical treatment data were analyzed and the surgical treatment plan was dis-cussed.Cervical X-ray,CT and MRI examinations were regularly performed after surgery to evaluate the con-ditions of complete resection of tumor and recurrence,the stability of the upper cervical spine and whether the internal fixation was loose or broken.The recovery of spinal nerve function and pain improvement were evaluated by the Japanese Orthopaedic Association(JOA)and visual analogue scale(VAS)scores.Results:All the patients underwent complete tumor resection in one stage,and the postoperative JOA score(10.14±1.55 vs 13.86±1.06,P=0.005)and VAS score(2.42±1.29 vs 0.64±0.71,P=0.000)were statistically different from those before surgery.Postoperative tumor histopathology was confirmed as schwannoma in all the 14 patients.The follow-up time was 6 months to 2 years.No recurrence of tumor was found,neurological symptoms were significantly improved,and no upper cervical instability appeared.Conclusions:For patients with intra-and extra-spinal dumbbell-shaped schwannoma in the upper cervical spine,complete resection of the tumor in one stage of posterior approach can be given priority.If the important stable tissue structure of the upper cervical spine is destroyed,upper cervical spine fixation and fusion should be performed to ensure the stabil-ity of upper cervical spine after tumor resection.
