Management of Paraspinal Nerve Sheath Tumors

Paraspinal nerve sheath tumors are defined as neoplasms lateral to the neural foramen, originating from the nerve sheath, sometimes with significant extra- and intraforaminal extension. The majority are schwannomas, with neurofibromas, and then much less common malignant peripheral nerve sheath tumors. Most are solitary lesions, but patients with NF1 and NF2 can have significant nerve sheath tumor burden and warrant special surgical considerations. Paraspinal nerve sheath tumors can be challenging pathologies to treat due to their ability to involve the entire spine and critical neurovascular structures associated with it. For high-grade or non-operable lesions, growing options for radiation and chemotherapy exist. Ultimately a well-trained and disciplined peripheral nerve surgeon has a great opportunity to improve the lives of these patients, many of whom have a surgically curable disease.