Background. Spinal schwannomas are common benign spinal tumors. Their treatment has significantly evolved over the years, and\npreserving neurological functions has become one of the main treatment goals together with tumor resection. Study Design and\nAims. Retrospective review focused on clinical assessment, treatment techniques, and outcomes. Methods. A retrospective study on\nour surgical series was performed. Clinical and operative data were analyzed. In regard to neurophysiologic monitoring, patients\nwere retrospectively divided into two groups comparing the outcomes before and after introduction of routine intraoperative\nneurophysiology tests. Results. From 1951 to 2010, 367 patients overall were treated. Diagnosis was obtained using angiography\nand/or myelography (pre-CT era), MRI, or CT scan. A posterior spinal approach was used for most patients; complex approaches\nwere adopted for treatment of giant/dumbbell tumors. A trend of neurophysiology monitoring decreasing the rate of post-op\nneurological deficits was observed but was not statistically significant enough to draft evidence-based conclusions. Conclusions.\nClinical and radiological assessment of spinal schwannomas has markedly changed over the course of 50 years. Diagnostic tools\nhave improved, and detection of recurrence has become way more sensitive. Neurophysiologic monitoring has become a useful\nintraoperative tool to guide resection and prevent post-op neurological impairment.
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