Minimally Invasive Resection of a Foraminal Lumbar Root Schwannoma

Abstract

Background and Importance

This video article reports a rare case of a right L5/S1 foraminal root schwannoma that presents the natural course of the disease, imaging findings, treatment protocol, operative procedure, and highlights some of the possible surgical complications.

Clinical Presentation

Magnetic resonance imaging (MRI) revealed an intradural, extramedullary, well-enhanced mass at the right L5/S1 level. The operative procedure involved a right minimal L5/S1 laminotomy/foraminotomy posteriorly to open the right L5 root. The facet joints were preserved to prevent spinal instability. The tumor was located along the root after opening the right L5/S1 foramen. Intraoperative electromyography (IOM) was conducted to detect any nerve injury in the patient. After opening the dura, the tumor was carefully separated from the normal root nerve under IOM monitoring. The mass was removed piece-by-piece using mini-forceps.

Conclusion

Histopathological examination confirmed the diagnosis of a schwannoma. The patient recovered without incident after surgery with minimal soreness and numbness in the right leg.

Video abstract

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Keywords:

• foraminal sacral root
• foraminotomy
• intradural extramedullary schwannoma
• laminotomy
• Schwannoma
• spine tumor

Compliance with Ethical Standards

The written informed consent was provided by the patient to have the case details and any accompanying images published. This study was exemption of Institutional Review Board (IRB) by Tainan Municipal An-Nan Hospital, China Medical University.

Consent Statement

The patient signed informed consent and publication of the data was authorized.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Tainan Municipal An-Nan Hospital, China Medical University (ANHRF111-49). The funder had no role in the organization of the research, in the decision to publish the research data, in the writing of the article content, or in the interpretation of the results, analysis, or data collection.