Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;165(10):3065-3076.
doi: 10.1007/s00701-023-05707-2. Epub 2023 Jul 4.

Is laminectomy necessary for C1-C2 epidural schwannomas?

Tae-Shin Kim  1 , Woon Tak Yuh  1   2 , Junghoon Han  1 , Junhoe Kim  1 , Chang-Hyun Lee  1 , Chi Heon Kim  1   3 , Chun Kee Chung  4   5   6
Affiliations

Is laminectomy necessary for C1-C2 epidural schwannomas?

Tae-Shin Kim et al. Acta Neurochir (Wien). 2023 Oct.

Abstract

Purpose: Spinal schwannomas often require laminectomy for gross total resection. However, laminectomy may not be necessary due to the unique anatomy of epidural schwannomas at the C1-2 level, even with the intradural part. This study aimed to determine the need for laminectomy by comparing factors between patients who underwent laminectomy and those who did not and to identify the benefits of not performing laminectomy.

Methods: Fifty patients with spinal epidural schwannoma confined to C1-C2 level were retrospectively collected and divided into groups based on whether laminectomy was intended and performed. In all cases where laminectomy was conducted, patients underwent laminoplasty using microplate-and-screws, which deviates from the conventional laminectomy approach. Tumor characteristics were compared, and a cut-off value for laminectomy was determined. Outcomes were compared between groups, and factors influencing laminectomy were identified. Postoperative changes in cervical curves were measured.

Results: The diameter of the intradural part of the tumor was significantly longer in the laminectomy performed group, with a 14.86 mm cut-off diameter requiring laminectomy. Recurrence rates did not differ significantly between groups. Surgery time was substantially longer for the laminectomy performed group. No significant changes were observed in Cobb's angles of Oc-C2, C1-C2, and Oc-C1 before and after surgery.

Conclusion: The study showed that the diameter of the intradural part of the tumor influenced the decision to perform laminectomy for removing epidural schwannomas at C1-C2. The cut-off value of the diameter of the intradural part of the tumor for the laminectomy was 14.86 mm. Not performing laminectomy can be a viable option with no significant differences in removal and complication rates.

Keywords: C1–C2; Epidural; Schwannoma; Spine; Tumor.

PubMed Disclaimer

References

    1. Baba H, Maezawa Y, Furusawa N, Imura S, Tomita K (1995) Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy. A radiographic study. Int Orthop 19:116–121. https://doi.org/10.1007/BF00179972 - DOI - PubMed
    1. Bartolomei JC, Crockard HA (2001) Bilateral posterolateral approach to mirror-image C-2 neurofibromas. Report of four cases. J Neurosurg 94:292–298. https://doi.org/10.3171/spi.2001.94.2.0292 - DOI - PubMed
    1. 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 (Phila Pa 1976) 41:390–398. https://doi.org/10.1097/BRS.0000000000001232 - DOI - PubMed
    1. George B, Lot G (1995) Neurinomas of the first two cervical nerve roots: a series of 42 cases. J Neurosurg 82:917–923. https://doi.org/10.3171/jns.1995.82.6.0917 - DOI - PubMed
    1. Heller JG, Edwards CC 2nd, Murakami H, Rodts GE (2001) Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: an independent matched cohort analysis. Spine (Phila Pa 1976) 26:1330–1336. https://doi.org/10.1097/00007632-200106150-00013 - DOI - PubMed

LinkOut - more resources