Lateral dural sleeve incision for rare S1 Root intradural schwannoma

Posted by Dr.Syed Ali Dr.Syed Ali
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18 years old female
College student
C/O pain over left gluteal region
Radiating upto left sole
Aggravated on walking for about 10 min, standing for long time, bending forward, also gets increased during sleeping
Relieved by taking medicines
No history of weakness of limbs, difficulty in holding chappals, difficulty in climbing upstairs
No history of sensory deficits
No history of bladder/bowel involvement

O/E:
Thin built
No spinal tenderness/deformity
Power – 5/5 all 4 limbs
No sensory deficits
DTR – reduced in left ankle
Plantar – bilaterally flexor
Sphincter – Normal tone and voluntary contraction
No neuro cutaneous markers

MRI-
Intradural extramedullary enhancing SOL at the level of L5-S1 on the left side with widening of the left neural foramina
Bilateral L5 and S1 roots enhancing lesion
S/O multiple neurofibroma / schwannoma
T1 sagittal and axial image showing intradural well defined lesion at L5-S1 level


T2 sagittal showing the lesion



Well enhancing lesion at L5-S1 level



Operative video:
Lateral dural sleeve incision for rare intradural S1 root schwannoma




Biopsy report: Schwannoma

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Dr. Thamburaj Dr. Thamburaj
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Re: Lateral dural sleeve incision for rare S1 Root intradural schwannoma

Interesting case , well presented.