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Peruvian Journal of Neurosurgery

Schwannoma of the cauda equina causing low back pain and bilateral crural paraparesis

Luciano Ferreira de H. MD, Rafael Rodriguez H. MD, Amauri Pereira da Silva MD, Jose da Acosta L. MD et Al.
Abstract (Spanish) || Full Text || PDF (Spanish)



Neuromas, neurinomas, or neurilemmomas are benign tumors of peripheral nervous system, which have Schwann cell origin. Typically, schwannomas are typically solitary, ovoid or spindle, as well encapsulated and found along the peripheral nerves or surrounded by them. The location of the tumor is prevalent in the cervical and thoracic, and less frequent in the lumbosacral spine Moreover, growth has dragged normally are not aggressive, not malignant and are subject to cure by surgery. The attempt to separate the tumor from its adjacent nerve is often successful, leading to a preservation of neural function. Patient 48 years, history of low back pain radiating to lower limbs, which worsened when performing the Valsalva maneuver. On physical examination it was found paraparesis, hypotonia and hyporeflexia in both lower limbs. The same bore resonance that showed strong and heterogeneous lesion predominantly located at the first lumbar vertebra in topography intradural, extramedullary, which has received too heterogeneous enhancement by Gadolinium. Patient underwent laminectomy involving the twelfth thoracic and first lumbar vertebra. The tumor assumed ellipsoid shape, was attached to a thin nervous from the cauda equina, this being duly resected. After the procedure has evolved in the same manner satisfactory recovery of neurological function. The complexity of the case and the presence of atypical schwannoma of cauda equina call attention in this case.

     Key words: Cauda eqüina; crural paraparesis; laminectomy; Schwannoma