Tumour distribution and characteristics associated with poor surgical outcomes in patients with sporadic spinal schwannomas

Acta Neurochirurgica, 2025 · DOI: https://doi.org/10.1007/s00701-025-06439-1 · Published: January 19, 2025

Simple Explanation

Spinal schwannomas are benign tumors that can compress the spinal cord or nerve roots, leading to neurological symptoms. Surgical resection is often performed, but some patients do not fully recover functionally after surgery. This study aims to identify factors, specifically related to the tumor's location and shape, that might predict who will have a less successful recovery after surgery for spinal schwannomas. The research found that tumors located in the thoracic spine and those that are not dumbbell-shaped are associated with a higher risk of residual neurological deficits after surgery.

Study Duration

January 2010 and March 2024

Participants

72 patients

Evidence Level

Not specified

Key Findings

1
Thoracic spine involvement is a significant risk factor for residual neurological deficits after surgery (OR, 5.03; 95% CI, 1.47–18.6; p = 0.01).
2
Dumbbell-shaped tumors are associated with a reduced risk of residual neurological deficits (OR, 0.15; 95% CI, 0.02–1.28; p = 0.04).
3
Thoracic spinal schwannomas are associated with a significantly higher incidence of persistent postoperative neurogenic pain compared to cervical or lumbosacral tumors (p = 0.001).

Research Summary

This study retrospectively reviewed data from 72 patients who underwent surgery for spinal schwannomas to identify factors associated with residual neurological deficits. The study found that thoracic spine involvement and the absence of a dumbbell shape were significant risk factors for residual neurological deficits. These findings can help surgeons refine preoperative assessments and improve surgical management to optimize patient outcomes.

Practical Implications

Preoperative Assessment

Thorough preoperative evaluations should consider tumor distribution (especially thoracic spine involvement) and morphology (dumbbell-shaped vs. non-dumbbell-shaped) to assess the risk of residual neurological deficits.

Surgical Planning

Surgical strategies for thoracic schwannomas and non-dumbbell-shaped tumors may need to be more aggressive or utilize advanced techniques (e.g., expanded laminectomy, intraoperative monitoring) to improve outcomes.

Patient Counseling

Patients with thoracic schwannomas or non-dumbbell-shaped tumors should be informed of the higher risk of residual neurological deficits and persistent postoperative neurogenic pain.

Tumour distribution and characteristics associated with poor surgical outcomes in patients with sporadic spinal schwannomas

Simple Explanation

Key Findings

Research Summary

Practical Implications

Preoperative Assessment

Surgical Planning

Patient Counseling

Study Limitations

Your Feedback

Was this summary helpful?

Tumour distribution and characteristics associated with poor surgical outcomes in patients with sporadic spinal schwannomas

Simple Explanation

Key Findings

Research Summary

Practical Implications

Preoperative Assessment

Surgical Planning

Patient Counseling

Study Limitations

Your Feedback

Was this summary helpful?