{"id":"385d35e4-7a02-45a8-b649-986083db81a6","slug":"gross-total-resection-of-a-large-conus-region-intradural-extramedullary-schwannoma-with-dense-adhesion-operative-video-and-11-year-follow-up","title":"Gross-total resection of a large conus-region intradural extramedullary schwannoma with dense adhesion: Operative video and 11-year follow-up","authors":["Masahiro Kawanishi","Naokado Ikeda","Yutaka Ito","Kunio Yokoyama","Makoto Yamada","Akira Sugie","Hidekazu Tanaka"],"abstract":"Background: Large conus-region tumors may be difficult to remove when the tumor–conus interface is indistinct and dense adhesion to the conus/rootlets is present. Case Description: A 47-year-old male with 4 years of leg pain and bladder dysfunction rapidly deteriorated to wheelchair dependence over 1 week. Magnetic resonance imaging showed a large thoracolumbar intradural extramedullary mass with an unclear interface with the conus. Emergency T12-L2 laminectomy was performed. After internal decompression, meticulous sharp dissection along the tumor–neural interface with preservation of surface microvasculature enabled identification of the root of origin and gross-total resection. Pathology confirmed schwannoma. Motor function recovered and he returned to work within 1 month, but sphincter dysfunction persisted. No recurrence was noted at 11 years. Conclusion: A stepwise strategy – sharp interface dissection with vascular preservation – can facilitate safe gross-total resection of large conus-region tumors despite dense adhesion or an ill-defined interface.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/385d35e4-7a02-45a8-b649-986083db81a6/featured/hero-1781557947237.png","publishDate":"2026-02-06T00:00:00.000Z","doi":"10.25259/SNI_1431_2025","categories":["Pediatric Neurosurgery","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/385d35e4-7a02-45a8-b649-986083db81a6/pdf"}