Evidence map›Paper›PMID 39825133›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Presentation and surgical management approaches of giant presacral and sacral schwannomas: a case report and systematic review and meta-analysis.

Khalid Sarhan, Ibrahim Serag, Amin Sabry, Hossam Elghareeb, Mostafa Shahein

Abstract readMeta-AnalysisSystematic Review
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In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Khalid SarhanFaculty of Medicine, Mansoura University, Mansoura, Egypt. kwssarhan@std.mans.edu.eg.ORCID 0009-0005-5474-4755
Ibrahim SeragFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Amin SabryDepartment of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Hossam ElghareebDepartment of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Mostafa ShaheinDepartment of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGiant sacral and presacral schwannomas are very rare conditions and their prevalence is estimated to account for only 0.3 to 3.3% of overall schwannomas. Current published literature about these tumors is limited to case reports and small case series. In this paper we systematically reviewed and analyzed the available literature on giant sacral schwannomas focusing on identifying the presenting symptoms, Klimo type, surgical approach, recurrence rate and postoperative complications.

methodsFollowing the PRISMA guidelines, we conducted a literature search on electronic databases to obtain the relevant studies until March 2024. We included reports of surgically managed giant sacral schwannomas; either involving tumor of at least 2 adjacent vertebra or had a maximum diameter of 5 cm or more. Presenting symptoms, tumor size, morphology, surgical approach and postoperative complications were reported.

resultsA total of 102 studies with 201 unique patients were included in our analysis (mean age 45.4 ± 9.8, 49.7% females). The most common presenting symptoms were lower extremity radicular pain (19.5%), lower back pain (14.1%), lower extremity numbness or paresthesia (9%), and constipation (7.6%). Most surgeries used an open posterior approach (40.1%) or open anterior approach (33.5%). Postoperative complications occurred in (29.3%) of patients and 10% had local recurrence or progression of their tumor. On linear regression the volume of the tumor could significantly predict the estimated amount of blood loss (P = 0.03). We found that an anterior approach was far more likely to be used in patients with Klimo type III, (P < 0.001). Similarly, posterior approach was mostly used for Klimo type I and type II (P < 0.001).

conclusionThe management approach of giant sacral and presacral schwannomas are mainly tailored according to the tumor size and location. Due to the benign nature and the overall recurrence rate of the tumor, frequent imaging follow-up is required after safe resection with adequate clean margins.

Indexed as

NeurilemmomaSacrumSpinal NeoplasmsAdultCase Reports as TopicFemaleHumansMaleMiddle AgedPostoperative ComplicationsGiant SchwannomasKlimo classificationPre-sacral and sacralSpinal tumorsSurgical management

Identifiers

PMID39825133

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