[Microsurgical treatment for giant invasive spinal schwannoma assisted by three-dimensional navigation].

OBJECTIVE: To summarize the clinical experience of microsurgical treatment for giant invasive spinal schwannoma assisted by three-dimensional navigation.

METHODS: A total of 15 cases of giant invasive spinal schwannoma were retrospectively analyzed from 2013 to 2014 in Beijing Jishuitan Hospital.All patients were performed microsurgery assisted by three-dimensional navigation and were followed up for at least 12 months.A modified McCormick Scale was used to assess the patients' neurologic status and change.

RESULTS: Four lesions were in the cervical region, 3 in the sacral, 2 each in the cervicothoracic, lumbar and thoracic regions, 1 each in the thoracolumbar and lumbosacral regions.A total of 28 pedicle screws were placed satisfactorily in the 5 patients with spinal instability.No severe complications were encountered.Gross total resection was performed in 13 of the 15 patients, and subtotal resection performed in 2 patients.Satisfactory decompression was achieved in all patients for neural compression.Postoperative clinical symptoms were improved in all patients, and none of the patients showed loosening or displacement of the implants.

CONCLUSIONS: Three-dimensional navigation provides great help for neurosurgeons in surgical treatment of giant invasive spinal schwannoma, and it has great potential in raising the intraoperative localization accuracy, reducing operational damage and surgical complications.Total resection is suggested for giant invasive spinal schwannoma; if not, total resection of the intraspinal portion is recommended.