Minimally Invasive Resection of a Foraminal Lumbar Root Schwannoma

Chien-Ching Lee; Hao-Yu Chuang; Che-Chao Chang; Hung-Lin Lin; Cheng-Hsin Cheng

doi:10.2147/IMCRJ.S445098

Minimally Invasive Resection of a Foraminal Lumbar Root Schwannoma

Int Med Case Rep J. 2024 Feb 12:17:125-129. doi: 10.2147/IMCRJ.S445098. eCollection 2024.

Authors

Chien-Ching Lee^{1

2}, Hao-Yu Chuang^{3

4}, Che-Chao Chang^{3

5}, Hung-Lin Lin⁶, Cheng-Hsin Cheng^{3

7}

Affiliations

¹ Department of Anesthesia, An Nan Hospital, China Medical University, Tainan, 70965, Taiwan.
² Department of Medical Sciences Industry, Chang Jung Christian University, Tainan, 71101, Taiwan.
³ Department of Neurosurgery, An Nan Hospital, China Medical University, Tainan, 70965, Taiwan.
⁴ Department of Neurosurgery, China Medical University Beigang Hospital, Yunlin County, 65152, Taiwan.
⁵ Neurophysiology Laboratory, Department of Surgery, National Cheng Kung University Medical Center and Medical School, Tainan, 70101, Taiwan.
⁶ Department of Neurosurgery, China Medical University Hospital, Taichung, 40447, Taiwan.
⁷ Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, 71101, Taiwan.

Abstract

Background and importance: This video article reports a rare case of a right L5/S1 foraminal root schwannoma that presents the natural course of the disease, imaging findings, treatment protocol, operative procedure, and highlights some of the possible surgical complications.

Clinical presentation: Magnetic resonance imaging (MRI) revealed an intradural, extramedullary, well-enhanced mass at the right L5/S1 level. The operative procedure involved a right minimal L5/S1 laminotomy/foraminotomy posteriorly to open the right L5 root. The facet joints were preserved to prevent spinal instability. The tumor was located along the root after opening the right L5/S1 foramen. Intraoperative electromyography (IOM) was conducted to detect any nerve injury in the patient. After opening the dura, the tumor was carefully separated from the normal root nerve under IOM monitoring. The mass was removed piece-by-piece using mini-forceps.

Conclusion: Histopathological examination confirmed the diagnosis of a schwannoma. The patient recovered without incident after surgery with minimal soreness and numbness in the right leg.

Keywords: Schwannoma; foraminal sacral root; foraminotomy; intradural extramedullary schwannoma; laminotomy; spine tumor.

Publication types

Case Reports

Grants and funding

This work was supported by the Tainan Municipal An-Nan Hospital, China Medical University (ANHRF111-49). The funder had no role in the organization of the research, in the decision to publish the research data, in the writing of the article content, or in the interpretation of the results, analysis, or data collection.