DOI: http://dx.doi.org/10.18203/2349-2902.isj20213986

Clinical profile, management and surgical outcome of spinal cord tumors

Shobhit Chhabra, Bhagirath More, Deepak Ranade, Sarang Gotecha, Prashant Punia, Vybhav Raghu, Dushyant Kashyap

Abstract


Background: Spinal cord tumors can result in dramatic neurological and functional disabilities in the patients. We aimed to know the incidence of different types of spinal tumors and correlation between clinical presentation and pathological findings and compare outcomes of these tumors postoperatively.

Methods: A total of 50 patients were included in the study group. After a thorough clinical evaluation, patients were subjected to a magnetic resonance imaging (MRI) and then surgery. They were described on the basis of age, sex, location of the tumor, type of the tumor, symptoms, histopathological type, surgical resection and complications.

Results: Study included 29 males and 21 females and their age ranged from 5 years to 70 years. Out of the 50 patients, 39 had intradural and 11 had extradural spinal tumors. Amongst the 39 intradural tumors, 27 were extramedullary and 12 were intramedullary in location. A predilection towards the thoracic region (44%) was seen followed by the cervical cord. The tumors were excised completely in 68% of the patients while subtotal resection was done in 18% and near total resection in 14% patients. There was significant drop in VAS score and improvement in McCormicks score at 3 months of follow up.

Conclusions: Based on this study it could be suggested that surgical excision and decompression should be attempted in all patients of intradural spinal tumor fit to undergo the procedure, as it not only helps in reaching a definitive histopathological diagnosis but also achieves neurological improvement in most patients without causing significant morbidity and mortality.


Keywords


Spinal cord tumors, Epidemiology, Pathological analysis, Outcome comparison

Full Text:

PDF

References


Liigant A, Asser T, Kulla A, Kaasik A. Epidemiology of primary central nervous system tumors in Estonia. Neuroepidemiology. 2000;19:300-11.

El-Mahdy W, Kane PJ, Powell MP, Crockard HA. Spinal intradural tumours: Part I–Extramedullary. Br J Neurosurg. 1999;13:550-7.

McCormick PC, Stein BM. Intramedullary tumors in adults. Neurosurg Clin N Am. 1990;1:609-30.

Klekamp J, Samii M. Surgical results for spinal meningiomas. Surg Neurol. 1999;52:552-62.

King AT, Sharr MM, Gullan RW. Spinal meningiomas: a 20-year review. Br J Neurosurg. 1998;12:521-6.

Lee RR. MR imaging of intradural tumors of the cervical spine. Magn Reson Imaging Clin N Am. 2000;8:529-40.

McCormick PC, Stein BM. Intramedullary tumors in adults. Neurosurg Clin North Am. 1990;1:609-30.

Bennet M Stein, Paul C. McCormick, Spinal intradural tumors. Wilkins RH, Rengachary SS, editors. Neurosurgery 2nd Ed Vol 2. New York, McGraw-Hill. 1994;1769-82.

Schwartz TH. McCormick PC. Spinal cord tumors in adults. Neurological surgery 5th edition 2nd Saunders (Philadelphia). 2015.

Constans JP, de Divitiis E, Donzelli R, Spaziante R, Meder JF, Haye C. Spinal metastases with neurological manifestations. Review of 600 cases. J Neurosurg. 1983;59(1):111-8.

Nakano S, Yoneyama T, Sugimoto T. Paramedian transmuscular access to C-3 dumbbell-type neurofibroma without muscle dissection from the spinous process or facetectomy. Technical note. J Neurosurg (Spine 1). 2003;99:121-4.

Levy WJ, Bay J, Dohn D. Spinal cord meningioma. J Neuro Surg. 1982;57:804-12.

Gilbert RW. Epidural spinal cord compression from metastatic tumors: diagnosis and treatment. Ann Neurol. 1978;3:40-51.

Black P, Nair S, Giannakopoulos. Spinal epidural tumors. Wilkins RH, Rengachary SS, editors. Neurosurgery. 2nd edition volume 2. McGraw-Hill, New York. 1994.

Ciapetta P, Domenicucci M, Raco M. Spinal meningiomas: Prognosis and in 22 cases with severe motor deficit. Acta Neurol Scand. 1988;77:27-30.

McCormick PC, Post KD, Stein BM. Intramedullary- extramedullary tumors in adults. Neursurg Clin N Am. 1990;1:591-608.

Parsa AT, McCormick PC. Intramedullary Spinal Tumors. Neurosurg Clin N Am. 2006;17(1).