The results of surgical treatment of sacral schwannomas with extension into pelvic cavity

Abstract

The aim. To analyze the results of surgical treatment of sacral schwannomas with their extension into lower pelvis.Materials and methods. We analyzed the clinical results of surgical treatment of 25 patients with sacral schwannomas, including those with ventral extension and growth into pelvic cavity. All patients were operated at the Clinic of Neurosurgery of the Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan for a 10-year period. The analysis of literature describing prevalence, classification, diagnosis and surgical treatment of sacral tumors and schwannomas in particular was carried out. The features of the course, diagnosis and surgical treatment of sacral schwannomas and accepted surgical methods for their treatment are described.Results. The average follow-up period of the patients in our study was 61.6 ± 2 months. Compared with the initial indicators of patients in the postoperative period (1 year after the surgery), a good clinical result with the regression of symptoms was registered in 17 (68 %) out of 25 patients, and 10 (40 %) of them had a significant regression of neurological disorders. 3 (12 %) operated patients had a deterioration of neurological disorders in the form of aggravation of sensitive disorders; one patient had an aggravation of pelvic organ dysfunction. Radical removal of the tumor was achieved in 24 (96 %) out of 25 cases; subtotal resection was performed in 1 (4 %) patient. The number of relapses and continued growth of tumors in our series was 12 % (3 out of 25 patients). The mortality rate was 0 %. The complications were registered in 3 (12 %) cases and manifested as wound liquorrhea in cases of using posterior approach.Conclusion. The degree of radicality of tumor resection and clinical outcomes is directly related to the selected surgical approach.