Abordaje combinado posterior y anterior con asistencia endoscópica a paciente con Schwannoma cervical. Presentación de caso

Abstract

Introduction: Schwannomas are neoplasms of neural origin, derived from the sheath of Schawnn. Its cervical location is very rare. They appear as slow- growing expansive masses most frequently in the carotid space. Surgical resection is the treatment of choice and is often complex due to the extent of the lesion and its relationship with nerve roots, which are difficult to preserve. Clinical case: A 50-year-old female patient is presented, referring to cervical pain of gradual onset and progressive worsening, unrelated to physical effort, of moderate intensity with three years of evolution, and irradiated towards the occipital and left scapular region. which later extended to the entire upper left limb. In Magnetic Resonance Imaging (MRI), an occupational lesion was observed at the level of C5-C6 that occupied the left conjunct foramen, intensely captured contrast and compromised the medullary canal, producing compressive ischemic myelopathy. A 360-degree cervical approach with endoscopic support was performed in two surgical stages with tumor excisión plus discectomy and C5-C6 arthrodesis with placement of a PEEK box. Conclusión: Cervical spinal schwannomas are rare conditions and their treatment represents a challenge. Total surgical resection is the treatment of choice. The 360-degree combined approach with endoscopic support is an effective tool for the management of these injuries.