The optimal approach to intradural tumors remains controversial. All the techniques may have advantages and disadvantages when applied alone. Combining two different techniques in a tailored way could be safer and more effective for individual patients. A 53-year-old female patient was admitted to our clinic with complaints of back pain, walking difficulty, and numbness in her left foot that had been going on for one and a half years. Gadolinium-enhanced: -enhanced T1-weighted magnetic resonance imaging of the thoracic spine revealed a contrast-enhanced intradural extramedullary mass lesion, ∼40 × 15 mm in size, with a cystic component; the lesion extended from the level of the lower end plate of the T7 vertebral body to the mid-level of the T9 vertebral body. The patient was operated on using a tailored laminoplasty–hemilaminectomy technique, and gross total resection of the intradural extramedullary large tumor was achieved. Gross total excision of large intradural extramedullary schwannomas can be safely performed using a tailored laminoplasty–hemilaminectomy approach, where unilateral hemilaminectomy can be performed at multiple levels, whereas laminoplasty is limited to a single level.

A abordagem ideal para tumores intradurais permanece controversa. Todas as técnicas podem ter vantagens e desvantagens particulares quando aplicadas isoladamente. Combinar duas técnicas diferentes de maneira personalizada pode ser mais seguro e eficaz para pacientes individuais. Uma paciente do sexo feminino, de 53 anos, foi admitida em nossa clínica com queixas de dor nas costas, dificuldade para caminhar e dormência no pé esquerdo, sintomas que duravam um ano e meio. A ressonância magnética da coluna torácica ponderada em T1 com contraste de gadolínio revelou uma lesão intradural extramedular com realce de contraste, aproximadamente 40 × 15 mm de tamanho, com um componente cístico; a lesão se estendia desde o nível da placa terminal inferior do corpo vertebral de T7 até o nível médio do corpo vertebral de T9. A paciente foi operada utilizando uma técnica personalizada de laminoplastia–hemilaminectomia, e foi alcançada a ressecção total macroscópica do grande tumor intradural extramedular. A excisão total macroscópica de grandes schwannomas intradurais extramedulares pode ser realizada com segurança usando uma abordagem de laminoplastia–hemilaminectomia personalizada, onde a hemilaminectomia unilateral pode ser realizada em vários níveis, enquanto a laminoplastia é limitada a um único nível.

The study was conducted in accordance with the Declaration of Helsinki for experiments involving human participants. The patient consented to the procedure and provided informed, written consent for the publication of this case report. All data was anonymized.

Original conception (NB), data collection and analysis (NB, MAK, SS, ATŞ, FÇ, TT, BEA), writing of the manuscript (NB, MAK, SS), revision of the manuscript (all the authors) and final approval (all the authors).

Received: 18 August 2024

Accepted: 09 June 2025

Article published online:
08 July 2025

© 2025. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil