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Spinal Schwannoma

About Spinal Schwannoma

A spinal schwannoma is a benign tumor or the nerve sheath, lining around the nerve, that may grow from a spinal nerve. Almost all spinal schwannomas are benign. These tumors can occur spontaneously or occur in people with neurofibromatosis, a genetic disorder that results in multiple tumors throughout the body. Most cases appear in people between the ages of 30 and 60 years old, although they can occur at any age.

Small, asymptomatic schwannomas are typically monitored with periodic imaging. Large schwannomas may cause nerve compression and are typically removed with surgery.

Common Symptoms of Spinal Schwannoma

As the tumor gets larger different parts of the spine, nerves, blood vessels and bones will be affected. Symptoms will vary but may include:

  • Back pain
  • Weakness/numbness in arms or legs
  • Difficulty controlling bladder/bowel function
  • Walking difficulty
  • Lost coordination

Diagnosis of Spinal Schwannoma

Review of a patient’s medical history and a physical exam are the first step in diagnosing a spinal schwannoma. The following imaging tests are then used to rule out other conditions and ensure a correct diagnosis.

  • Magnetic resonance imaging (MRI) scan: is the imaging of choice to define the location and impact that the tumor has on surrounding structures, such as the spinal cord.
  • Computerized tomography (CT) scan:  a noninvasive procedure that produces images of the spine, and any the relationship between the tumor and other structures, such as the spinal cord

Treatment Options for Spinal Schwannoma

Variables including the patient’s age, overall health, and the size and location of the tumor determine whether or not surgery is necessary to remove the schwannomas. Some other treatment options include:

  • Monitoring – if a schwannoma is small, not growing, or posing any risks, or if the patient is not a good candidate for surgery, surgeons may choose to monitor the tumor as the best treatment option
  • Surgery – removal of the tumor may be the best option to relieve pressure on the spinal cord and nerves.
    • Microsurgery – with the assistance of microscopic visualization, the tumor is usually completely resected.
    • Stereotactic Radiosurgery – another minimally invasive technique that uses radiation beams at many angles to treat tumors. This is rarely used for spinal schwannomas and reserved for more aggressive tumors or if a patient cannot tolerate surgery.