Spinal intradural tumours: Part I-extramedullary

Abstract

Sixty-six patients had surgery for an intramedullary nerve sheath tumour under the care of one surgical team in a 16-year period. Surgery concentrated on radical intra- and extradural excision combined if necessary with vertebral column reconstruction. Ninety procedures were used in 35 males and 30 females with an age range 12-81 years. Forty-five per cent were located in the cervical, 26% in the thoracic and 29% in the lumbosacral region. Eighteen patients had NF1 and two patients NF2. Sixty-five per cent were schwannomas, 27% were mixed histology and 6% malignant. In terms of functional outcome, 37 patients improved by one or more Frankel grades, three deteriorated by one Frankel grade and no one who presented with symptoms alone deteriorated. There were no operative deaths; no instrumentation failures and five patients developed a CSF leak.

Surgical Outcomes of Spinal Tumour: Experiences of 48 Cases at Referral Neurosurgery Hospital in Bangladesh

“…Next to pain, 18.7% (09 cases) 10.4% (05 cases) and 4.2% (02 cases) patients presented with motor disturbances, sensory disturbances and sphincter disturbances respectively as initial symptom. This report can be compared to the report of other series [10] where pain, motor and sensory disturbances were present as initial symptom in 60%, 24.2% and 15.8% cases respectively.…”

“…No patient developed meningitis and there was no postoperative death in this series. CSF leakage and subsequent meningitis was the greatest problem in the series of both Mahdy et al (1999) and Jenkinson et al (2006). There was also 2.6% post-operative death in the series of Jenkinson et al (2006).…”

“…In terms of functional outcome, it was considered that the Frankel grading system has provided much more useful way to display the individual and collective changes following surgery which do not unexpectedly depend on the deficit at time of presentation as well as effects of surgery [10].…”

“…The surgery should better carry out by single surgical team employing microsurgical techniques when necessary. Great effort should be made to remove the tumors completely [10]. Therefore, the purpose of the present study was to see the outcome of the spinal tumour surgery.…”

Outcome predictors and complications in the management of intradural spinal tumours

“…Some authors advise an aggressive surgical approach [8,9,17,20] but we adopt a different stance with the minimum bone removal to maintain spinal column stability and avoid the need for instrumentation, which makes post-operative MRI interpretation difficult. Only three patients deteriorated post-operatively, two remained ambulant, and one patient, who initially improved, developed MRSA meningitis leading to paralysis.…”