Spinal Schwannomas

What is a spinal schwannoma?

The Schwann cells are a type of cell that surrounds nerve cells and produces a protective covering known as myelin. These Schwann cells surround the spinal nerve roots that extend out from the spinal cord and form the nerves that extend across the rest of the body. Spinal Schwannomas are a type of spinal tumor that occurs within these Schwann cells on the spinal nerve roots. Most of these types of tumors are non-cancerous (benign) and grow very slowly. Dr. Brenton Pennicooke, MD, spinal tumor specialist, treats patients in St. Louis, St. Peters, Creve Coeur, and the surrounding cities in St. Louis County, and St. Charles County, Missouri who are experiencing symptoms associated with a spinal schwannoma.

What causes a spinal schwannoma?

The specific cause of spinal schwannomas is currently unknown. Most cases of spinal schwannomas appear to have occurred randomly (sporadically), with no apparent cause or origin. However, it is believed that genetics has a strong role in determining a patient’s risk factor for developing this type of spinal tumor. Most patients diagnosed with a spinal schwannoma are middle-aged, and those with a family history of spinal cancers have a greater risk of developing this type of tumor.

What are the symptoms of a spinal schwannoma?

Most patients with a spinal schwannoma experience no symptoms at all. Patients that develop symptoms may experience:

• Pain near the site of the tumor
• Neck or back pain that worsens at night or while sleeping
• Weakness, numbness, or tingling in the arms and or legs
• Difficulties with balance or coordination

The symptoms caused by spinal schwannomas are a result of the tumor compressing a section of the spinal roots or spinal cord itself. Therefore, the symptoms will likely vary in location depending on the section of the spine affected by the tumor.

How are spinal schwannomas diagnosed?

To diagnose a spinal schwannoma, Dr. Pennicooke will first review a detailed medical history, including a review of the patient’s symptoms and concerns. He may also perform a physical examination that includes reflex, strength, coordination, and sensation tests. Dr. Pennicooke will also order diagnostic imaging tests, such as an MRI or a CT scan, that will allow him to determine the size and location of the spinal schwannoma.

What is the treatment for a spinal schwannoma?

Dr. Pennicooke will review each patient’s specific tumor, symptoms, and goals in order to create the best treatment plan for each patient.

Non-surgical treatment:

• Observation: Patients that do not experience symptoms may be treated by simply observing the spinal schwannoma over time. This includes having diagnostic imaging tests performed intermittently over the course of many years to detect if any changes occur.
• Radiation: for tumors that may be difficult to access surgically, small tumors that qualify, and tumors that invade other surrounding tissue, radiation treatment can be used.
• Chemotherapy: some patients may benefit from chemotherapy if their spinal schwannoma is large or invades nearby tissue

Surgical treatment:

If the patient is experiencing symptoms as a result of a spinal schwannoma, surgical removal of the tumor can be used as a treatment option. During this operation, Dr. Pennicooke will remove the tumor using a small incision and specialized surgical microscopic techniques. Patients with larger tumors may require additional surgical stabilization of their spine and surrounding tissues.