title: Intraosseous schwannoma of D12 thoracic vertebra: diagnosis and surgical management with 5-year follow-up.
abstract: Intraosseous schwannomas or neurilemomas are rare benign neoplasms that account for less than 0.2% of primary bone tumours. Very rarely they have been observed in lumbar vertebrae. We report a neurilemoma involving the lower thoracic spine and present the clinical, radiological and histological findings with surgical management and 5-year follow-up. An 18-year-old-male presented with back pain and deteriorating locomotor function. Neurological examination revealed wasting of both calves and weakness in plantar flexion and dorsiflexion bilaterally. X-rays showed a D12 vertebral body abnormality with cystic changes and collapse of the body and pedicle. MRI showed a tumor occupying the D12 vertebrae with perivertibral protrusion compressing the thecal sac. Surgical decompression, excision and stabilisation with an extendable cage, bone graft and anterior rod system were achieved through a thoracolumbar approach. Histology results confirmed an intraosseous schwannoma with no remnants of an originating nerve. These tumors are rare but can be successfully treated with surgical excision and maintenance of spinal stability with recovery of neurological and functional change. Recurrence is uncommon.
authors.affiliation: Department of Orthopaedics, Royal Preston Hospital, Preston, Lancashire, PR2 9HT, UK. doctorqc2004@yahoo.co.uk
authors.forename: Qaisar
authors.initials: Q
authors.lastname: Choudry
authors.forename: Fizan
authors.initials: F
authors.lastname: Younis
authors.forename: Roger B
authors.initials: RB
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000209:etiology; D019299:Decompression, Surgical; D004388:Dura Mater / Q000293:injuries; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008279:Magnetic Resonance Imaging; D008297:Male; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery*; D019635:Neurosurgical Procedures; D020335:Paraparesis / Q000209:etiology; D019736:Prostheses and Implants; D011859:Radiography; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome