# Utilization of the Lateral Extracavitary Approach for the Resection of a Giant Extradural Paraspinal Schwannoma: A Case Report

## TL;DR

This case report describes the successful use of a lateral extracavitary approach to remove a large spinal tumor, resulting in significant symptom improvement for the patient.

## Contribution

The paper demonstrates the effectiveness of the lateral extracavitary approach for resecting a giant extradural paraspinal schwannoma.

## Key findings

- The lateral extracavitary approach enabled gross total resection of a large extradural paraspinal schwannoma.
- The patient experienced significant symptomatic resolution following the procedure.
- LECA minimized morbidity and provided adequate access for a technically challenging resection.

## Abstract

Spinal schwannomas are benign neoplasms originating from the spinal nerve sheath and account for around one-third of primary spine neoplasms. The most common treatment modality for these tumors is complete surgical resection. Compared with intradural tumors, the resection of an extradural spinal schwannoma is generally associated with a more complex approach, including longer incisions and increased lateral exposure. One useful surgical technique is the lateral extracavitary approach (LECA), which enables dorsal and ventrolateral access to the thoracolumbar spine with decreased rates of morbidity. Herein, the authors describe this approach for the resection of a giant extradural paraspinal schwannoma.

A 74-year-old female patient presented with right flank pain and difficulty breathing during strenuous exercise. Imaging revealed a large 8.5 × 5.2 × 6.3 cm solid paraspinal lesion spanning from T11-L2 vertebral body levels, with mass effect on the right posterior diaphragm and lung. Before surgical resection, the lesion was confirmed to be a schwannoma by needle biopsy. A LECA approach was used, achieving gross total resection. At 1-month follow-up, the patient reported great symptomatic resolution.

LECA proved to be an instrumental approach in a technically challenging resection of a giant extradural paraspinal schwannoma.