What Is a Neuroma Excision?

There are three cases of the relationship between schwannomas and spinal cord: located on the dorsal side of the spinal cord; located on the ventral or front side of the spinal cord; dumbbell-shaped tumors.

Schwannoma resection

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Meningiomas grow from the dura mater, mostly on the dorsal or lateral side of the spinal cord, and a few can be on the ventral side of the spinal cord. The base is generally broad. For example, on the dorsal side of the spinal cord, the tumor is separated from the spinal cord, and then removed with the dura mater attached to the tumor, and the blood is stopped by bipolar electrocoagulation [see Figures 1-1 and 2]. The defective dura mater can be repaired with fascia [Figure 4-5]. If the defect is not large, it may not be repaired, but the muscle layer must be tightly sutured. A small part of the dural tumor is cured in front of the spinal cord and the basal mass is wide. Only the corresponding dentate ligaments can be cut [Fig. 2-2]. After gently flipping and protecting the spinal cord, bipolar electrocoagulation is used to cauterize the meningiomas. Envelope, bite off the tumor contents with a curette or biopsy forceps [Figure 2-3]. Then try to cut off the exposed capsule and attached dura mater. Defective ventral meninges may not be repaired.

1. There are often arachnoid cysts around schwannomas. During surgery, do not only be satisfied with the treatment of arachnoid cysts and miss the tumor. Careful exploration should be performed to confirm that there is no tumor before aborting the operation.

2. For tumors with a wide range of condyles and spinal cords, such as tuberculoma, lipoma, etc., they should not be separated unreasonably. It is best to make frozen sections during surgery to determine the pathological properties, and perform total resection, major resection or spine according to their properties. Decompression of the plate and so on.

3. When part of the tumor is removed outside the spinal canal, when removing the ribs and pushing open the pleura, pay attention to prevent pneumothorax caused by pleural injury. If epidural anesthesia is used and the pneumothorax is heavy, the patient may have difficulty breathing. Therefore, it is better to use tracheal intubation for general anesthesia for this type of surgery. At the end of the operation, ask the anesthesiologist to expand the lungs to eliminate the accumulation of gas in the chest cavity. .

Same as spinal canal-spinal cord exploration.