Peripheral nerve tumors: surgical principles, approaches, and techniques

The surgical treatment of peripheral nerve sheath tumors is dependent on the tumor's neoplastic nature and its anatomic location. Surgical principles for nerve sheath tumors focus on surgical decision making common to all peripheral nerve sheath tumor operations and then on that particular to a given tumor type. Surgical approaches for nerve sheath tumors vary according to the local anatomy. Exposure on an extremity is relatively straightforward, but as the location becomes more proximal, anatomy conspires to protect nerves, plexuses, and the spinal cord, making surgical exposure more difficult. As a consequence, selected surgical approaches to nerve sheath tumors in these more protected areas are specifically described.