Surgical Treatments of Intradural Extramedullary Tumor

Shin, Byung-Joon; Lee, Jae Chul; Yoon, Tae-Kyung; Jung, Han‐Yong; Han, Sun Wook; Kim, Dong-Won; Kim, Kyung-Je; Kim, Yon-Il

doi:10.4184/jkss.2002.9.3.230

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…This was attributed to the difficulty in making an early diagnosis because the tumors grow slowly, produce vague symptoms in the early stages, and present with pain and radiating pain similar to those found in lower lumbar disc diseases 5). For these reasons, as was the case in the study by Shin et al,4) there was a delay from the development of subjective symptoms to admission in this study, an average of 59.4 months in the present study. Therefore, it is believed that spinal cord tumors should also be taken into consideration as a possible diagnosis when a patient complains of symptoms that are usually found in lower lumbar disc diseases, such as intervertebral disc herniation and spinal stenosis.…”

Section: Discussionsupporting

confidence: 71%

“…1 , 2) Common clinical symptoms in patients with tumors are pain and paresthesia in the abdomen and the lower limbs, motor abnormality, and dysuria. 2 , 3) According to Shin et al, 4) while abdominal pain is the first subjective symptom, most patients complain of paresthesia and motor abnormalities at the time of admission. This was attributed to the difficulty in making an early diagnosis because the tumors grow slowly, produce vague symptoms in the early stages, and present with pain and radiating pain similar to those found in lower lumbar disc diseases.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Results of Intradural Extramedullary Tumors

et al. 2009

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BackgroundTo report the treatment results of 12 patients who underwent a total excision of intradural extramedullary tumors.MethodsTwelve cases of histopathologically confirmed intradural extramedullary tumors were treated surgically between February 2002 and March 2005. There were 8 males and 4 females with an average age of 42.6 years. The mean postoperative follow-up period was 24.2 months. The histopathological findings, locations of the tumors, and clinical results were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel classification.ResultsThe histopathological results are as follows: 4 cases of a meningioma, 4 cases of a schwannoma, 2 cases of an epidermoid cyst, 1 case of an arachnoid cyst, and 1 case of an ependymoma. The locations of the tumors were as follows: 7 cases in the thoracic region, 4 cases in the lumbar region, and 1 case in the cervical region. At the final follow-up, a 2-grade and 1-grade improvement was observed in 1 and 7 cases, respectively. There were no changes in the Frankel grade in 4 cases. The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Postoperatively, there were 2 cases of cerebrospinal fluid leakage and 2 cases of paresthesia.ConclusionsIntradural extramedullary tumors detected by MRI are mostly benign and good clinical results can be obtained when treated surgically. Therefore, more active surgical approaches by orthopedic surgeons are recommended to decrease morbidity.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Surgical Results of Intradural Extramedullary Tumors

et al. 2009

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“… 17) The recent development of radiological examinations has helped to prevent such misdiagnoses, but thoracic tumors were overlooked and lumbar lesions were surgically treated in 2 cases of this study. According to Shin et al 18) as the clinical symptoms of a tumor are similar to those of the herniation of an intervertebral disc and spinal stenosis, taking a detailed history, conducting a thorough physical examination and performing MRI scans on the proximal regions are recommended for patients with back pain and radiating pain in the lower limbs. In this study, the surgical intervention for lesions that could result in neurological symptoms in the distal area did not lead to improvements of the symptoms.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Treatment for Spinal Intradural Extramedullary Tumors

Ahn¹,

Park²,

Choi³

et al. 2009

Clin Orthop Surg

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BackgroundWe wanted to investigate the results of surgical treatment and analyze the factors that have an influence on the neurologic symptoms and prognosis of spinal intradural extramedullary (IDEM) tumors.MethodsThe spinal IDEM tumor patients (11 cases) who had been treated by surgical excision and who were followed up more than 1 year were retrospectively analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade. The pathological diagnosis, the preoperative symptom duration, the tumor location on the sagittal and axial planes and the percentage of tumor occupying the intradural space were investigated. In addition, all these factors were analyzed in relation to the degree of the preoperative symptoms and the prognosis. On the last follow-up, the MRI was checked to evaluate whether or not the tumor had recurred.ResultsThe most common diagnosis was schwannomas (73%), followed by meningiomas (18%). The percentage of tumor occupying the intradural space was 82.9 ± 9.4%. The VAS score was reduced in all cases from 8.0 ± 1.2 to 1.2 ± 0.8 (p = 0.003) and the Nurick's grade was improved in all cases from 3.0 ± 1.3 to 1.0 ± 0.0 (p = 0.005). The preoperative symptoms were correlated with only the percentage of tumor occupying the intradural space (VAS; r2 = 0.75, p = 0.010, Nurick's grade; r2 = 0.69, p = 0.019). One case of schwannoma recurred.ConclusionsThe degree of neurologic symptoms was correlated with the percentage of tumor occupying the intradural space. All the tumors were able to be excised through the posterior approach. The postoperative neurologic recovery was excellent 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.

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“…In our study, similarly, Schwannoma was 15 cases, and Neurofibroma was one case. Shin et al 7) have reported that based on pathohistological diagnosis, Schwannoma was most prevalent, and as the site, the most prevalent site was the thoracic region. Nonetheless, most nerve sheath tumors are frequently observed in the lumbosacral region than the cervical region or the thoracic region because Cauda equina is present in the lumbosacral region.…”

Section: Resultsmentioning

confidence: 99%