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Research article
CHUNMEI CHEN
Fujian Medical University Union Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4483-7465
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Study Design: A case report.
Objective: To describe the first case of GISS with VBC in the cervical spine, analyze the clinical features and surgical outcomes, and discuss diagnosis and treatment strategies.
Summary of Background Data: The giant invasive spinal schwannoma (GISS) extends more than two vertebral levels, erodes the vertebral body and extends posteriorly and laterally into the myofascial plane. To the best of our knowledge, never before has there been a report of GISS with vertebral body collapse (VBC).
Methods: A 44-year-old man was admitted as a result of a 1-year history of limb weakness and defecation difficulties. Power were reduced in all limbs: right upper limb middle finger muscle strength was 2/5, both lower limb hip flexion and knee flexion muscle strength was 3/5, and the muscle strength of the remaining limbs was 0/5. Preoperative MRI revealed that an extradural tumor, localized at the C3 to C5 levels, invaded the C4 vertebral body and attachment. A two-stage operation by posterior and anterolateral approaches was performed. One year after surgery, the patient could walk and write unassissted, and strength was regained to 4/5 in the upper extremities and 5/5 in the lower extremities. MRI showed no recurrence of the tumor. CT showed good fusion of the vertebral bodies, and X-ray films confirmed stable fixation materials without loosening or displacement. The bowel function has improved though patient remains only able to defecate in bed.
Conclusions: We herein describe the case of GISS with VBC in the cervical spine. Paired with imaging for malignant features, MRIs meeting the criteria for GISS diagnosis may reveal similar cases that could be preoperatively evaluated by biopsy for optimal surgical planning.
Keywords
Spinal schwannoma, giant invasive spinal schwannoma, GISS, vertebral body collapse, VBC, magnetic resonance imaging, MRI, Computed temography, CT
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This is a preprint. It has not completed peer review.
Research article
CHUNMEI CHEN
Fujian Medical University Union Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4483-7465
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 04 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Study Design: A case report.
Objective: To describe the first case of GISS with VBC in the cervical spine, analyze the clinical features and surgical outcomes, and discuss diagnosis and treatment strategies.
Summary of Background Data: The giant invasive spinal schwannoma (GISS) extends more than two vertebral levels, erodes the vertebral body and extends posteriorly and laterally into the myofascial plane. To the best of our knowledge, never before has there been a report of GISS with vertebral body collapse (VBC).
Methods: A 44-year-old man was admitted as a result of a 1-year history of limb weakness and defecation difficulties. Power were reduced in all limbs: right upper limb middle finger muscle strength was 2/5, both lower limb hip flexion and knee flexion muscle strength was 3/5, and the muscle strength of the remaining limbs was 0/5. Preoperative MRI revealed that an extradural tumor, localized at the C3 to C5 levels, invaded the C4 vertebral body and attachment. A two-stage operation by posterior and anterolateral approaches was performed. One year after surgery, the patient could walk and write unassissted, and strength was regained to 4/5 in the upper extremities and 5/5 in the lower extremities. MRI showed no recurrence of the tumor. CT showed good fusion of the vertebral bodies, and X-ray films confirmed stable fixation materials without loosening or displacement. The bowel function has improved though patient remains only able to defecate in bed.
Conclusions: We herein describe the case of GISS with VBC in the cervical spine. Paired with imaging for malignant features, MRIs meeting the criteria for GISS diagnosis may reveal similar cases that could be preoperatively evaluated by biopsy for optimal surgical planning.
Figure 1
Figure 2
Figure 3
Figure 4
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