{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:17:22Z","timestamp":1790299042253,"version":"4.1.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Affiliated Hospital of Jining Medical University","award":["ZZTD-2020-010"],"award-info":[{"award-number":["ZZTD-2020-010"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1,3]]},"abstract":"\n Rationale:<\/jats:title>\n Giant spinal schwannomas located at the C1-C2 level pose significant surgical challenges because of their proximity to the brainstem, cervical spinal cord, and vertebral arteries. This case provides insight into the surgical management of giant spinal schwannomas at the C1-C2 level.<\/jats:p>\n <\/jats:sec>\n \n Patient Concerns:<\/jats:title>\n A 40-year-old female presented with a 2-year history of progressive limb numbness, weakness, and gait instability. She reported a sensation of stepping on cotton and tightness in the chest and abdomen with worsening symptoms over time.<\/jats:p>\n <\/jats:sec>\n \n Diagnoses:<\/jats:title>\n Physical examination revealed limited cervical spine movement, increased muscle tone in the limbs, and Hoffmann and Babinski signs. Imaging, including CT, CTA and MRI, identified a large schwannoma at the C1-C2 level, with compression of the spinal cord and proximity to the vertebral artery.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n The patient underwent surgical excision of the tumor using full laminectomy approach under intravenous anesthesia.<\/jats:p>\n <\/jats:sec>\n \n Outcomes:<\/jats:title>\n The surgery was successfully completed, and the patient\u2019s neurological symptoms, including numbness and weakness, were significantly relieved.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Strict enucleation within the capsule can effectively protect the vertebral artery and nearby nerves. When functional nerve roots or the spinal cord are involved, leaving the residual capsule may be safer than risking permanent deficits.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/md.0000000000041258","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T14:06:12Z","timestamp":1736258772000},"page":"e41258","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["A giant spinal schwannoma at the C1-C2 level: A case report"],"prefix":"10.1097","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7542-8019","authenticated-orcid":false,"given":"Xiaodong","family":"Wu","sequence":"first","affiliation":[{"name":"Jining Medical University, Jining, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dazhi","family":"Li","sequence":"additional","affiliation":[{"name":"Jining Medical University, Jining, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Jining Medical University, Jining, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3312-4643","authenticated-orcid":false,"given":"Yanming","family":"Li","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Jining Medical University, Jining, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2 Suppl","key":"R1-20250909","first-page":"210","article-title":"Giant invasive spinal schwannomas: definition and surgical management.","volume":"94","author":"Sridhar","year":"2001","journal-title":"J Neurosurg"},{"key":"R2-20250909","doi-asserted-by":"crossref","first-page":"e34966","DOI":"10.1097\/MD.0000000000034966","article-title":"Mobile schwannoma of the lumbar spine: a case report and literature review.","volume":"102","author":"Song","year":"2023","journal-title":"Medicine (Baltim)"},{"key":"R3-20250909","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.nec.2004.02.007","article-title":"Paraspinal nerve sheath tumors.","volume":"15","author":"Dorsi","year":"2004","journal-title":"Neurosurg Clin N Am"},{"key":"R4-20250909","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2176\/nmc.ra.2014-0421","article-title":"Surgical Strategies for cervical spinal neurinomas.","volume":"55","author":"Ito","year":"2015","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"R5-20250909","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.wneu.2019.11.099","article-title":"Intraspinal canal schwannoma with extensive calcification: case report and literature review.","volume":"134","author":"Zhong","year":"2020","journal-title":"World Neurosurg"},{"key":"R6-20250909","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3171\/2015.3.SPINE141218","article-title":"How do spinal schwannomas progress? 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Risk of neurological deficit after resection of involved root.","volume":"71","author":"Kim","year":"1989","journal-title":"J Neurosurg"},{"key":"R11-20250909","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/00006123-200209000-00012","article-title":"Treatment of relevant nerve roots involved in nerve sheath tumors: removal or preservation?","volume":"51","author":"Celli","year":"2002","journal-title":"Neurosurgery"},{"key":"R12-20250909","doi-asserted-by":"crossref","first-page":"494","DOI":"10.3171\/2016.9.SPINE16778","article-title":"Sowash M, Ori Barzilai O, Kahn S, et al. Clinical outcomes following resection of giant spinal schwannomas: a case series of 32 patients.","volume":"26","year":"2017","journal-title":"J Neurosurg Spine"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000041258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T18:01:54Z","timestamp":1757440914000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000041258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000041258","relation":{},"ISSN":["1536-5964"],"issn-type":[{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}