title: Treatment results in the differential surgery of intradural extramedullary schwannoma of 110 cases.
abstract: METHODS
  A retrospective study of intradural extramedullary schwannoma.
  
  
  OBJECTIVE
  The purpose of this study was to compare treatment results in the differential surgery of intradural extramedullary schwannoma.
  
  
  BACKGROUND
  A reference guide to the surgical procedures available to treat intradural extramedullary schwannoma has not yet been established.
  
  
  METHODS
  The study retrospectively reviewed 110 patients: Group A: laminectomy+microscopic excision; Group B: hemilaminectomy+microscopic excision; Group C: laminectomy+microscopic excision+pedicle screw fixation. Researchers selected patients for this retrospective review by applying the following criteria: 1) back pain spread out from the tumor level, sensory and motor loss; 2) treatment by surgery; 3) clinical diagnosis made by physical examination, magnetic resonance imaging (MRI), and pathology; 4) a minimum clinical and radiologic follow-up of 12 months. The clinical outcomes were assessed by comparing the Visual Analogue Pain Scores (VAS) and the Japanese Orthopedic Association Scores (JOA score). The study also performed a cost-effectiveness analysis.
  
  
  RESULTS
  Cervical vertebrae: The estimated blood loss in Group B was significantly less than in Group C (P<0.05) (Table 1). Thoracic vertebrae: The duration of hospital stay and estimated blood loss in Group A was significantly less than in Group C (P<0.05) (Table 2, 3). Lumbar vertebrae: The resection rate in Group C was significantly higher than in Group A and Group B (P<0.05) (Table 4). Treatment in Group B was the least expensive, and therefore, the most cost-effective.
  
  
  CONCLUSIONS
  In the case of appropriate surgical indications, the study suggests that hemilaminectomy+microscopic excision is advantageous in the removal of cervical schwannoma, and that laminectomy+microscopic excision is advantageous in the removal of thoracic schwannoma; lumbar intradural extramedullary schwannoma can be managed by laminectomy+microscopic excision+pedicle screw fixation.
authors.affiliation: Department of Spine Osteopathia, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China. zongshaohui@yahoo.cn
authors.forename: Shaohui
authors.initials: S
authors.lastname: Zong
authors.forename: Gaofeng
authors.initials: G
authors.lastname: Zeng
authors.forename: Chunxiang
authors.initials: C
authors.lastname: Xiong
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000191:economics / Q000379:methods; D008297:Male; D008866:Microsurgery / Q000191:economics / Q000379:methods; D008875:Middle Aged; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult