{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:00:44Z","timestamp":1786125644571,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Dumbbell tumors present challenging cases, with either an incomplete tumor resection or a need to sacrifice nerve roots. Published literature suggests encouraging neurological outcomes after nerve root amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine the incidence of postoperative neurological deficits after amputating the parent nerve root.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective consecutive analysis of all patients treated for dumbbell nerve sheet tumors with a reported amputation of the functional relevant parent nerve roots C5-Th1 and L3-S1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 21 evaluated patients, minor postoperative neurological motor function deterioration occurred in 4 patients (19%). Most patients recovered to the preoperative level at the follow-up examination, and only one patient retained a new Medical Research Council (MRC) scale of 4\/5 for deltoid weakness. The majority of tumors were resected at the lumbar level (nerve root L3: 28.6%, L5: 19%). Gross total resection was achieved in 90.5% of patients. Neuropathic pain was reported in one third of the patients during the long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Amputating critical parent nerve roots during the dumbbell tumor resections seems to result in a low incidence of postoperative motor deficits and may offer an acceptable sacrifice in otherwise only incompletely resectable dumbbell tumors. The cross-innervation of neighboring nerve roots and its, probably, per-se-reduced functionality may be a possible mechanism for maintaining motor function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opaa365","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T10:34:19Z","timestamp":1609238059000},"page":"260-267","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["A Case Series of Surgically Treated Spinal Dumbbell Tumors of Critical Parent Nerve Roots: To Cut or Not to Cut?"],"prefix":"10.1227","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0421-7974","authenticated-orcid":false,"given":"Vicki Marie","family":"Butenschoen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"K\u00f6gl","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudius","family":"Thom\u00e9","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Wostrack","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,3]]},"reference":[{"issue":"2","key":"bib1-20251027","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s11060-007-9507-z","article-title":"Descriptive epidemiology of primary spinal cord tumors","volume":"87","author":"Schellinger","year":"2008","journal-title":"J Neurooncol"},{"key":"bib2-20251027","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3389\/fneur.2017.00318","article-title":"Non-syndromic spinal schwannomas: a novel classification","volume":"8","author":"Sun","year":"2017","journal-title":"Front Neurol"},{"issue":"5","key":"bib3-20251027","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/BRS.0000000000001232","article-title":"Risk factors for recurrence of surgically treated conventional spinal schwannomas: analysis of 169 patients from a multicenter international database","volume":"41","author":"Fehlings","year":"2016","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"bib4-20251027","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/00000658-192708000-00008","article-title":"Further experiences with intra-thoracic tumors","volume":"86","author":"Heuer","year":"1927","journal-title":"Ann Surg"},{"issue":"2 Suppl","key":"bib5-20251027","first-page":"210","article-title":"Giant invasive spinal schwannomas: definition and surgical management","volume":"94","author":"Sridhar","year":"2001","journal-title":"J Neurosurg"},{"key":"bib6-20251027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2017\/3568359","article-title":"Spinal nerves schwannomas: experience on 367 cases-historic overview on how clinical, radiological, and surgical practices have changed over a course of 60 years","volume":"2017","author":"Lenzi","year":"2017","journal-title":"Neurol Res Int"},{"issue":"1","key":"bib7-20251027","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0090-3019(03)00537-8","article-title":"Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature","volume":"61","author":"Conti","year":"2004","journal-title":"Surg Neurol"},{"issue":"4","key":"bib8-20251027","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1227\/NEU.0000000000000890","article-title":"The long-term outcome after resection of intraspinal nerve sheath tumors: Report of 131 consecutive cases","volume":"77","author":"Halvorsen","year":"2015","journal-title":"Neurosurgery"},{"issue":"6","key":"bib9-20251027","doi-asserted-by":"crossref","first-page":"810","DOI":"10.3171\/jns.1989.71.6.0810","article-title":"Surgery of spinal nerve schwannoma. 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