Surgical Outcome in IDEM Tumors in Short Term Follow Up

Abstract

Background: To review the clinical and histological aspect of IDEM tumors with functional outcome after surgery of all radiologically diagnosed cases of IDEM. Methods: 12 cases of IDEM tumors, which had been surgically treated and studied in terms of clinical features as pain by VAS, functional score by Nuricks grading, in preoperative and postoperative period. The correlation of histopathology and tumor size in terms of clinical features and outcome was done. Results: Most common diagnosis was schwannoma (83.3%) and rest 2 patients were meningiomas(16.7%), distribution -3(25%) dorsal, 5(41.6%) lumbar, 2(16.6%) cervical, 1(8%) cervico-dorsal and 1(8%) dorso-lumbar and average percentage of the intradural space occupied by tumor was 77.02%. Average age was 40 years. Meningioma was common in 55 to 60 yr age all female; schwannoma the mean age was 37 year. The most common symptoms were local pain, tingling and numbness, motor weakness which were observed in all the cases. All patients improved postoperatively. VAS score and Nurick grade inproved in all. Conclusion: Most common pathology was schwannoma then meningioma. All the tumors excised through the posterior approach. The postoperative recovery was good in all the cases regardless of any condition. Therefore, aggressive surgical excision is recommended even for cases with a long duration of symptoms or a severe neurologic deficit.

Multidisciplinary Management and Outcome of Intradural Extramedullary Spinal Tumors

“…Considering factors influencing prognosis a longer duration of preoperative complaints, severe neurological deficit, 2 more proximal tumor location 3 & a tumor more ventral to the spinal cord showed a worse outcome. However, in our study & a few more studies 19,20 functional neurology & pain improvement were affected by the maximum %age of tumor engaging the intradural space rather than preoperative length of the period of symptomatology, as all patients had improvement on VAS & modified McCormick scale post-operatively irrespective of the length of duration of disease. But as these are rare tumors & the sample size is small in most of the available literature & even in our study so it may be a statistical error.…”