Schwannomas resection

Extraspinal spinal subdural tumors account for about 55% to 67% of myeloma, mainly neuronal schwannomas (neurofibroma) and meningioma. Both of these are benign tumors with a capsule that can be cured after resection, and must be completely removed during surgery. The relationship between schwannomas and the spinal cord can be divided into three cases: 1 located on the dorsal side of the spinal cord. 2 Located in the ventral or lateral front of the spinal cord. 3 dumbbell shaped tumors. Treatment of diseases: intracranial tumor neurofibroma Indication Extradural spinal epithelial tumors. Surgical procedure 1. Incision: Centered on the lesion, about 3cm from the spinous process, as a vertical or curved incision. 2. Resection of the intraspinal portion of the tumor: After the skin is cut, the latent shape is separated from the spinous process (ie, the median line of the back). The lamina was removed according to the procedure of laminectomy, the dura mater was exposed, cut open, the tumor was separated, the intraspinal portion of the tumor was partially removed, and the tumor protruding outside the intervertebral foramen was pulled into the spinal canal for resection. If the tumor is protruding more and cannot be pulled in, the tumor stump of the intervertebral foramen can be pushed out with a blunt device. If the dura mater is small, it can be sutured directly. If the defect is large, the fascia is used for repair. 3. Resection of the extraspinal portion of the tumor (the majority of the dumbbell-shaped nerve sheath occurs in the thoracic vertebrae, so as an example), the trapezius muscle and the rhomboid muscle are cut under the original skin incision, the sacral spine muscle is opened, and the small blood vessel is ligated. , revealing ribs and transverse processes. The number of ribs to be resected is determined according to the size of the tumor (generally no more than 2 to 3). Subperiosteal dissection, resection of the selected rib spine end about 4 ~ 6cm and the transverse process of the spine, ligation and cutting of intercostal blood vessels, nerves and muscle bundles, push open the pleura, reveal the tumor, separate the adhesion around the tumor to remove the tumor.