Functional Outcomes following Surgical Management of Intradural Extramedullary Spinal Cord Tumors

Abstract

Background Data: Intradural extramedullary tumors are mostly benign lesions that often present late due to their slow rate of growth. Recent advances in the field of neuro-imaging have greatly increased the ability to identify these tumors in early stages. The most effective treatment modality for these tumors is gross total resection, which can sometimes be associated with neurological morbidity and functional impairment. Purpose: to evaluate the functional outcomes following surgical excision of intradural extramedullary spinal tumors. Study Design: This is a retrospective cohort clinical case study. Patients and Methods: In this study the medical records of patients who underwent surgery for intradural extramedullary tumors at Ain Shams University Hospitals and Banha University Hospital between 2012 and 2015 were reviewed. Patient’s demographics, clinical presentation, radiographic findings, tumor location, histopathological findings and neurological outcome were documented from patients’ files. Pain was evaluated by Visual Analog Scale and neurological function was graded before and after surgery by Nurick’s Functional Grading System. Results: This study included sixteen patients with intradural extramedullary mass lesions. Six were males (37%) and 10 were females (63%), mean age at presentation was 41 years (range 24 to 63 years). Histopathologically, there were 10 schwannomas (62%), 4 meningioma (%25) and 2 Neurofibromas (%13). Based on the location, we had 9 thoracic, 3 cervical and 3 lumbar lesions. There was improvement of the mean VAS score from 7.8 preoperative to 1.6 postoperative, as well as the mean Nurick’s grade from 3.1 preoperatively to1.6 postoperatively. Conclusion: Intradural extramedullary tumors are almost benign and slowly growing lesions that may be asymptomatic for many years before presentations. These tumors can be surgically excised through a standard posterior approach. Favorable outcome can be achieved by early diagnosis andearly treatment with maximal tumor resection. (2015ESJ100)

Keywords

• Intradural extramedullary tumors
• spinal cord tumors
• functional outcome
• Nurick’s Functional Grading