Spinal schwannomas are the benign tumors arising from the nerve root sheath and account for 25% of all spinal tumors in adults. Giant spinal schwannomas are rare in the thoracic spine and pose a surgical challenge for complete excision. All the patients in our series underwent parascapular costotransversectomy approach, and this article aims at the surgical steps, merits, and demerits of the approach.
Materials and methods: Five patients with giant thoracic spinal schwannomas presented with nonspecific symptoms were diagnosed and operated by the authors at D3 to D5 levels. All the patients underwent complete tumor excision in a single stage by parascapular costotransversectomy approach.
Results: Totally, 5 patients (4 females and 1 male) with ages varying from 40 to 52 years underwent complete tumor excision in a single stage by parascapular costotransversectomy approach. No major complication was noted in our series. One patient developed transient nerve root deficit, which improved over 2 months.
Conclusion: Parascapular costotransversectomy approach for complete excision of giant thoracic spinal schwannomas is a safe and effective approach. It provides direct access to the lesion and does not necessitate spinal instrumentation.