Spinal intraosseous schwannoma: a retrospective study of 63 cases focusing on diagnosis, surgical strategies, and prognosis

Purpose To investigate the clinical diagnosis, surgical treatment strategies, and prognosis of spinal intraosseous schwannoma (SIS). Methods A retrospective analysis of clinical data from SIS patients treated at our hospital was conducted. Results From 2014 to 2023, 592 schwannoma patients were treated in our department. Among them, 67 cases exhibited spinal osseous invasion, with 63 patients being regularly followed up. These included 26 cervical lesions, 14 thoracic lesions, and 23 lumbar lesions. Except for 9 patients who experienced tumor recurrence following resection at other hospitals, all primary cases were diagnosed as schwannomas via percutaneous biopsy before surgery. Enhanced and reconstructed three-dimensional computed tomography (CT) and magnetic resonance imaging (MRI) revealed vertebral invasion and osteolytic bone destruction in all cases, with pathological fractures observed in 6 cases. The Visual Analog Scale (VAS) score decreased from 4.17 ± 2.24 preoperatively to 0.94 ± 1.07 at the final follow-up. No tumor recurrence was observed during the 2-year follow-up period. Conclusion This retrospective study provides valuable insights into the diagnosis, treatment, and classification of SIS. It highlights the importance of accurate preoperative diagnosis, appropriate surgical interventions, and long-term follow-up in ensuring optimal outcomes for patients with this rare condition.