Minimally invasive resection of a lumbar extradural schwannoma: how I do it

  • Giulia CossuEmail author
  • Juan Barges-Coll
  • Mahmoud Messerer
How I Do it - Tumor - Schwannoma
Part of the following topical collections:
  1. Tumor – Schwannoma



Complete surgical resection of a foraminal lumbar schwannoma may require an extended surgical exposure and facetectomy and thus secondary instrumentation. The minimally invasive technique through the use of tubular retractors may represent a valid surgical alternative.


We describe the resection of a foraminal lumbar schwannoma through the use of tubular retractors, along with its advantages and limitations. A limited medial facetectomy was performed and no stabilization was needed.


Minimally invasive surgery is suitable for an efficient and safe resection of foraminal schwannomas and may help in avoiding stabilization when a limited facetectomy is performed.


MetrX Minimally invasive spine surgery Schwannoma Tubular retractor 


Compliance with ethical standards

Patient consent statement

The patient/next of kin/guardian has consented the study “How I Do It” for submission to the journal.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

Video 1

In this video the authors show a minimally invasive approach through the use of tubular retractors for the resection of an extradural lumbar schwannoma. With the use of expandable retractors, the important bony landmarks were identified and after drilling of the lateral portion of the lamina and the medial third of the articular process, the schwannoma was identified. The intraoperative electrophysiological neuromonitoring helped us in localizing motor fibers and thus in performing a complete resection (MP4 182,622 kb)


  1. 1.
    Celli P, Trillo G, Ferrante L (2005) Spinal extradural schwannoma. J Neurosurg Spine 2:447–456CrossRefGoogle Scholar
  2. 2.
    Donner TR, Voorhies RM, Kline DG (1994) Neural sheath tumors of major nerves. J Neurosurg 81:362–373CrossRefGoogle Scholar
  3. 3.
    Fehlings MG, Nater A, Zamorano JJ, Tetreault LA, Varga PP, Gokaslan ZL, Boriani S, Fisher CG, Rhines L, Bettegowda C, Kawahara N, Chou D (2016) Risk factors for recurrence of surgically treated conventional spinal schwannomas: analysis of 169 patients from a multicenter international database. Spine 41:390–398CrossRefGoogle Scholar
  4. 4.
    Kim P, Ebersold MJ, Onofrio BM, Quast LM (1989) Surgery of spinal nerve schwannoma. Risk of neurological deficit after resection of involved root. J Neurosurg 71:810–814CrossRefGoogle Scholar
  5. 5.
    Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG (2005) A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 102:246–255CrossRefGoogle Scholar
  6. 6.
    Kratzig T, Dreimann M, Klingenhofer M, Floeth FW, Krajewski K, Eicker SO (2015) Treatment of large thoracic and lumbar paraspinal schwannoma. Acta Neurochir 157:531–538CrossRefGoogle Scholar
  7. 7.
    Lee S, Srikantha U (2015) Surgical management of giant lumbar extradural schwannoma: report of 3 cases. Int J Spine Surg 9:18CrossRefGoogle Scholar
  8. 8.
    Lu DC, Dhall SS, Mummaneni PV (2009) Mini-open removal of extradural foraminal tumors of the lumbar spine. J Neurosurg Spine 10:46–50CrossRefGoogle Scholar
  9. 9.
    Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O (1995) Long-term outcome after removal of spinal neurofibroma. J Neurosurg 82:572–577CrossRefGoogle Scholar
  10. 10.
    Shah M, Kaminsky J, Vougioukas VI (2008) Minimally invasive removal of an extradural intraradicular lumbar schwannoma. Acta Neurochir 150:691–693 discussion 693-694CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Giulia Cossu
    • 1
    • 2
    Email author
  • Juan Barges-Coll
    • 1
    • 2
  • Mahmoud Messerer
    • 1
    • 2
  1. 1.Spinal Surgery Unit, Department of NeuroscienceLausanne University HospitalLausanneSwitzerland
  2. 2.Department of NeurosurgeryLausanne University HospitalLausanneSwitzerland

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