Staged operation for huge cervical intramedullary schwannoma: report of two cases.

Abstract

We sought to describe a minimally invasive two-stage operation for huge cervical intramedullary schwannomas. Two patients with intramedullary schwannomas at C1-C2 and C5-C7 underwent two-stage surgery. In both patients, preoperative magnetic resonance imaging revealed the presence of a large tumor. The first surgery included partial tumor removal and duroplasty. At the time of the second operation performed 10 days later, the residual tumor was removed completely. Magnetic resonance imaging performed before the second operation demonstrated marked degeneration of the tumor in one patient and recovery of the spinal cord in both. We succeeded in removing the residual tumors entirely during the second operation. Neither patient manifested new neurological deficits, although one of the patients experienced transient left-hand weakness. Our two-stage operation is very useful for the resection of huge intramedullary schwannomas and preserves neurological function.