Clinical Effect of Laminectomy with Lateral Mass Screw Fixation in Treating Cervical Schwannoma: A Retrospective Study

Abstract

Background. The objective of this study was to evaluate the clinical effectiveness and safety of laminectomy combined with lateral mass screw fixation in treating cervical intradural extramedullary schwannoma. Methods. We retrospectively collected and analyzed medical records of 38 patients who underwent resection of cervical intraspinal schwannoma between January 2012 and April 2019. Based on different surgical procedures, two groups were divided among all participants: laminectomy-only (n=21) and laminectomy with instrumented fixation (n=17); the minimum follow-up time was 1 year. The visual analogue scale (VAS) score and neck disability index (NDI) were utilized for pain assessment; the Japanese Orthopedic Association (JOA) score was carried out for the assessment of neurological impairment. Radiographic changes of Cobb angle were compared before and after the surgery. Results. Consequently, demographics were well matched in both groups, without any statistical difference (P>0.05). Compared with preoperation, both surgical procedures significantly improved VAS, NDI, and JOA scores (P<0.001), but no differences between them (P>0.05). In terms of postoperative spinal instability/deformity, laminectomy-only caused more events than instrumented fixation, which is statistically significant (P<0.001). Conclusions. In summary, laminectomy with lateral mass screw fixation is an effective and safe approach to treat cervical intraspinal schwannoma, which is likely to be a better choice than the laminectomy-only approach.