Objective:

To evaluate the surgical feasibility, technical refinements, and clinical outcomes of resecting a giant paravertebral retroperitoneal schwannoma using the Weaver intermuscular approach, while emphasizing key anatomical considerations and potential pitfalls.

Key Findings:

• The tumor measured 90 × 108 × 122 mm and was compressing adjacent structures, highlighting the complexity of the case.
• The Weaver approach allowed for safe and effective resection with minimal morbidity, suggesting its potential as a preferred technique.
• Technical refinements included trajectory planning and preservation of retroperitoneal integrity, which are critical for surgical success.

Interpretation:

The Weaver intermuscular approach is a viable alternative for resecting large paravertebral retroperitoneal schwannomas, minimizing surgical morbidity and preserving spinal stability, with implications for future surgical strategies.

Limitations:

• The study is based on a single case, limiting generalizability.
• Further studies are needed to validate the effectiveness of the Weaver approach in larger cohorts, including long-term follow-up data.

Conclusion:

The case demonstrates the effectiveness of the Weaver approach for complex schwannomas, highlighting the importance of meticulous technique, patient selection, and its relevance compared to traditional methods.