Tailored Single-Level Laminoplasty and Multilevel Unilateral Hemilaminectomy Approach for Large Thoracic Intradural Schwannoma

Abstract

The optimal approach to intradural tumors remains controversial. All the techniques may have advantages and disadvantages when applied alone. Combining two different techniques in a tailored way could be safer and more effective for individual patients. A 53-year-old female patient was admitted to our clinic with complaints of back pain, walking difficulty, and numbness in her left foot that had been going on for one and a half years. Gadolinium-enhanced: -enhanced T1-weighted magnetic resonance imaging of the thoracic spine revealed a contrast-enhanced intradural extramedullary mass lesion, similar to 40 x 15 mm in size, with a cystic component; the lesion extended from the level of the lower end plate of the T7 vertebral body to the mid-level of the T9 vertebral body. The patient was operated on using a tailored laminoplasty-hemilaminectomy technique, and gross total resection of the intradural extramedullary large tumor was achieved. Gross total excision of large intradural extramedullary schwannomas can be safely performed using a tailored laminoplasty-hemilaminectomy approach, where unilateral hemilaminectomy can be performed at multiple levels, whereas laminoplasty is limited to a single level.