What are spinal neurinomas?

A spinal neurinoma is a benign tumor that grows slowly in our spine. A neurinoma can develop in all the sections of the peripheral nervous system, starting from its envelope cells (Schwann's cells). They can grow within (70%) and outside (20%) the meninges and in 10% like an hourglass, together with the peripheral nerves, they leave the spinal canal through the neural foramen. However, the preferred locations of a neurinoma are the cerebellopontine angle (acoustic neuroma) or the sensitive nerve roots in the spinal cord. Spinal neurinomas are particularly common in the upper and middle spine segments (cervical and thoracic spine). Neurofibromatosis causes multiple neurinomas. The particular thing about the neurinoma is not the neurinoma itself, but the repression and possible destruction of the surrounding tissues. The neurinoma is usually surrounded by a connective tissue capsule.

Neurinomas affect men and women equally

Neurinomas represent 30% of all primary benign spinal tumors. In contrast to meningiomas, neurinomas occur relatively equally in both sexes and at any age: however, they are most common between the 4th and 6th decade of people's life. Neurinomas can be found in 45% of cases in the thoracic spine, 30% in the cervical one and 25% in the lumbosacral one.

Causes of a neurinoma - the benign tumor that develops from Schwann's cells

A neurinoma, this benign tumor of the peripheral nervous system, develops from the so-called Schwann cells, which are responsible for the formation of nerve sheaths. The synonyms for the neurinoma are 'schwannoma', 'neurilemmoma' and 'benign peripheral nerve sheath tumor' (BPNST).

Symptoms - neurinoma and radiating pain

Neurinomas themselves are not painful, but they cause pain through pressure on the surrounding structures. If the tumor is still small, usually it does not cause discomfort but if its volume and pressure increases, the pain worsens. Huge neurinomas often pinch the nerve roots of sensitive nerves and often displace neighboring nerves, causing health problems. The pain or sensory disturbances are not always in the same place. It depends on the direction in which the neurinoma expands. For example, when neurinoma is seated in the lumbar spine, compression of nerves causes chronic back pain that can radiate to the legs. It will radiate to the arms if the neurinoma is located in the cervical spine and in the chest when tumors are located in the thoracic spine. A neurinoma in the spinal canal can even lead to paraplegia.

Diagnosis of neurinoma - if there are changes in your body, go see a doctor immediately!

Please notice: the terms 'benign' and 'good' must not be confused because even with benign tumors a clarification must be done as soon as possible in order to avoid serious consequences and ideally prevent them. Therefore, if you notice changes - pain, swelling, small ulcers - on your body, you should run to the arms of a trustful specialist. Sure, not every pain in the spine area suggests a tumor - but if it's one, while growth progresses through progressive compression it will lead to pain, numbness, and weakness of the affected nerve roots. As always: the sooner you get treated the better the chances of success are. The first step in diagnostics is always the doctor-patient interview (anamnesis). From a thorough physical and neurological examination, the decision depends on whether the specialist orders a magnetic resonance imaging (MRI) or a computed tomography (CT). With the help of contrast agent, you can see where the tumor sits and how big is it. And after the appropriate classification, the doctor can decide what he recommends to do with the tumor: to continue observing it or to intervene.

Therapy - spinal neurinomas must be completely removed

If the neurinoma is incidental and does not cause discomfort because of its small dimension, the benign tumor can be monitored by MRI regularly (follow-up). In case of a needed surgery it will be microsurgical which consists of removing the neurinoma completely. In more than 90% of all cases, the complete removal of the tumor succeeds. If it fails, the process of removal can be repeated. Rarely follows radiotherapy afterward.

Neurinomas have a very good prognosis

Most patients are cured after therapy and they can regain control of their lives. After its complete removal, the neurinom does not appear again. After the surgical procedure, patients should rest and protect themselves, for example, trying to avoid unnecessary stress. Important: Take regular precautions and, in case of unusual symptoms, consult immediately a specialist to clarify them.

Dr. med. Munther Sabarini

Author
Dr. med. Munther Sabarini
Specialist in Neurosurgery

Hans-Heinrich Reichelt

Co-author
Hans-Heinrich Reichelt
Chief Editor of Medizin für Menschen

The Avicenna Clinic in Berlin is always willing to help you

Since the year 2001, the Avicenna Clinic is based in Berlin. Our doctors have at least 25 years of international experience in their respective fields (neurosurgery, spinal surgery, anesthesia, and orthopedics).

If you have severe back pain, a herniated disc or a suspected herniation, please contact us using the following information:

Avicenna Clinic
Paulsborner Str. 2
10709 Berlin

Telephone: +49 30 236 08 30
Fax: +49 30 236 08 33 11
E-Mail: info@avicenna-klinik.de

You can call anytime, write an e-mail or fill out a callback form. Each patient then gets an appointment with a doctor of our clinic, who is a spine specialist (neurosurgeon). Based on MRI images (brought or made in our clinic) and on an in-depth examination, the doctor will discuss with you all the different therapy options or possibly surgery. You can also use our specialists only to obtain a (second) opinion.

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