Schmannomas in brachial plexus and peripheral nerves:surgical treatment of 38 cases / 中国矫形外科杂志

ABSTRACT

[Objective]To investigate the key points of treatment and effect of schmannomas in brachial plexus and peripheral nerves.[Method] Thirty-eight cases of schwannomas in brachial plexus and peripheral nerves were verified with pathology and clinical from 1999 to 2007.There were one case in accessory nerve,2 cases in cervical plexus cutaneous nerve,6 cases in brachial plexus,2 cases in lumbar plexus,17 cases in upper extremity,10 cases in lower extremity.Microsurgical removal of the tumors was done in 37 cases.They were monitored with negro-electro phsiology in operation.The other one case was repaired for nerve grafting after the tumor was cut off.The complexed parts were all examined with MRI before surgery,and all tumors were verified for schwannoma with pathyology.[Result]In 38 cases,there were no function deficit and recurrence over a period of follow up from 6 months to 7 years in 36 cases.The partial intrinsic muscle palsy was present postoperatively in one case of the schwannomas in ulnar nerve with microsurgery of tumor,and recovered after 10 days.After the schwannoma in L4 nerves were cut off and the nerves was grafted,the myodynamia of quadriceps femoris were decreased two degree below,the treatment effect of nerve grafting were being followed up. [Conclusion](1)The technique of microsurgery was used under the microscopic operating,the tumors should be cut off for the most degree to decrease the recurrence possibility,remain the normal neuro-function.(2) The MRI examination should be carried out before the schwannoma operating in the complex pares of the crans,brachial plxus,lumbar plexus and etc.(3) All the schwannoma should be verified by pathyology after surgery.