{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T18:04:45Z","timestamp":1770401085554,"version":"3.49.0"},"reference-count":8,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Large conus-region tumors may be difficult to remove when the tumor\u2013conus interface is indistinct and dense adhesion to the conus\/rootlets is present.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 47-year-old male with 4 years of leg pain and bladder dysfunction rapidly deteriorated to wheelchair dependence over 1 week. Magnetic resonance imaging showed a large thoracolumbar intradural extramedullary mass with an unclear interface with the conus. Emergency T12-L2 laminectomy was performed. After internal decompression, meticulous sharp dissection along the tumor\u2013neural interface with preservation of surface microvasculature enabled identification of the root of origin and gross-total resection. Pathology confirmed schwannoma. Motor function recovered and he returned to work within 1 month, but sphincter dysfunction persisted. No recurrence was noted at 11 years.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n A stepwise strategy \u2013 sharp interface dissection with vascular preservation \u2013 can facilitate safe gross-total resection of large conus-region tumors despite dense adhesion or an ill-defined interface.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1431_2025","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T07:29:39Z","timestamp":1770362979000},"page":"74","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gross-total resection of a large conus-region intradural extramedullary schwannoma with dense adhesion: Operative video and 11-year follow-up"],"prefix":"10.25259","volume":"17","author":[{"given":"Masahiro","family":"Kawanishi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naokado","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunio","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Sugie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidekazu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"10.25259\/SNI_1431_2025\/ref-1","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1038\/sc.2011.67","article-title":"Myxopapillary ependymoma: Correlation of clinical and imaging features with surgical resectability in a series with long-term follow-up","volume":"49","author":"Al-Habib","year":"2011","journal-title":"Spinal Cord"},{"key":"10.25259\/SNI_1431_2025\/ref-2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1055\/s-0036-1572376","article-title":"Giant cystic cum solid schwannoma of conus medullaris: A rare case report and review of literature","volume":"5","author":"Bansal","year":"2016","journal-title":"Indian J Neurosurg"},{"key":"10.25259\/SNI_1431_2025\/ref-3","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s007010070063","article-title":"Extramedullary hemangioblastoma of the conus medullaris","volume":"142","author":"Brisman","year":"2000","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_1431_2025\/ref-4","doi-asserted-by":"crossref","first-page":"429","DOI":"10.25259\/SNI_590_2021","article-title":"Myxopapillary ependymomas; Proximity to the conus and its effect on presentation and outcomes","volume":"12","author":"Helal","year":"2021","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1431_2025\/ref-5","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jos.2018.07.005","article-title":"Differentiation of spinal myxopapillary ependymomas from schwannomas by contrast-enhanced MRI","volume":"23","author":"Ito","year":"2018","journal-title":"J Orthop Sci"},{"key":"10.25259\/SNI_1431_2025\/ref-6","doi-asserted-by":"crossref","first-page":"536","DOI":"10.2176\/nmc.49.536","article-title":"Intramedullary schwannoma of the conus medullaris complicated by dense adhesion to neural tissue","volume":"49","author":"Ohtonari","year":"2009","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_1431_2025\/ref-7","doi-asserted-by":"crossref","first-page":"CASE2145","DOI":"10.3171\/CASE2145","article-title":"Intradural, extramedullary hemangioblastoma at the level of the conus medullaris: Illustrative case","volume":"1","author":"Shields","year":"2021","journal-title":"J Neurosurg Case Lessons"},{"key":"10.25259\/SNI_1431_2025\/ref-8","first-page":"e71139","article-title":"Characteristics of the preoperative and surgical findings in patients with bladder dysfunction after surgery for spinal myxopapillary ependymoma","volume":"9:16","author":"Yamada","year":"2024","journal-title":"Cureus"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/gross-total-resection-of-a-large-conus-region-intradural-extramedullary-schwannoma-with-dense-adhesion-operative-video-and-11-year-follow-up\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/gross-total-resection-of-a-large-conus-region-intradural-extramedullary-schwannoma-with-dense-adhesion-operative-video-and-11-year-follow-up\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T07:29:41Z","timestamp":1770362981000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/gross-total-resection-of-a-large-conus-region-intradural-extramedullary-schwannoma-with-dense-adhesion-operative-video-and-11-year-follow-up\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":8,"alternative-id":["10.25259\/SNI_1431_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1431_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,6]]},"article-number":"74"}}