Percutaneous full endoscopic tumourectomy of a lumbar epidural schwannoma via transforaminal approach: a case report and systematic review of the literature.

ABSTRACT

STUDY DESIGN: Report of three patients undergoing lumbar epidural schwannoma tumourectomy. Percutaneous endoscopy has been routinely used in the treatment of disk herniation but has not been reported in the management of intraspinal tumours. METHODS: Three patients diagnosed with schwannoma by imaging and pathological examination underwent percutaneous full endoscopic tumourectomy. A 5-mm incision was made, the puncture needle passed through the skin, subcutaneous tissue and the deep fascia and vertebral muscles to the intervertebral foramen area. Next, a working cannula was inserted into the lesion area. Foraminotomy was completed by trephine and microscopic power drill if the foramen was stenosed. Tumour tissue was totally removed piecemeal. After probing the nerve foramen and the nerve root satisfactorily, the working cannula was removed and the incision sutured. RESULTS: Three patients were operated successfully. Symptoms recovered in all cases and no complication or recurrence was found on follow-up. CONCLUSIONS: This case report presents a new technique for non-infiltrating extradural lumbar tumour treatment, demonstrating feasibility and safety of percutaneous full endoscopic lumbar tumourectomy.