From the Research
The treatment approach for a patient with vertebral neurofibroma typically involves surgical resection when the tumor is symptomatic or growing, with complete surgical excision being the preferred treatment, as evidenced by the high frequency of spinal neurofibromas and their potential for progression and cord compression 1. The goal of treatment is to remove the tumor while preserving neurological function.
- For asymptomatic, small, or incidentally discovered neurofibromas, observation with regular MRI monitoring may be appropriate, considering the natural history of these tumors and the potential for growth or malignant transformation.
- Radiation therapy may be considered for patients who are poor surgical candidates or have residual tumor after surgery, though it's generally reserved for malignant transformation cases.
- Pain management with medications such as gabapentin, pregabalin, or tricyclic antidepressants may be necessary for symptomatic relief. The specific surgical approach depends on tumor location, size, and relationship to surrounding structures, with options including posterior laminectomy, anterior approaches, or combined procedures, as informed by imaging techniques such as MRI 2, 3. Multidisciplinary care involving neurosurgeons, orthopedic spine surgeons, neurologists, and pain specialists is essential for optimal outcomes, taking into account the patient's age, overall health, tumor characteristics, and associated conditions like neurofibromatosis type 1 or 2, which may require more comprehensive management 4, 5.