Intradural Extramedullary Spinal Tumors – A Review of Modern Diagnostic and Treatment Options and a Report of a Series of 40 Cases

Vol 32| Issue 1 | Jan – June 2019 | page: 41-45 | Suresh S Pillai, M Harishankar


Authors: Suresh S Pillai [1], M Harishankar [1]

[1] Department of Orthopaedics, Baby Memorial Hospital, Calicut, kerala, India.

Address of Correspondence

Dr. Suresh S Pillai.
Consultant Spine surgeon Baby Memorial Hospital, Calicut, kerala, India.
E-mail: sureshorth@googlemail.com


Abstract

Spinal tumors are uncommon lesions and affect only a minority of the population. Spinal tumors comprise 15 % of all CNS tumors, with an incidence of 2-10 per 1,00,000. Location of the tumor is the most important aspect in the diagnosis of spinal tumor with regard to treatment and prognosis. Extradural lesions are more common (60% of all spinal tumors), with majority of lesions originating from the vertebrae. The clinical symptoms are often nonspecific and include back pain, radicular symptoms, and slowly progressive neurological deficits. Primary and most important diagnostic modality for intradural spinal tumors is MRI scan. Contrast material (defining the extent of intramedullary neoplasms and identifying areas of blood brain barrier break-down) and multiplanar imaging have broadened the use of MRI. Gross total tumor resection while preserving and improving the neurological function is the usual goal of surgery. If the complete removal of the tumor demands removal of more than one column of the spine, instrumented fusion of the adjacent levels may be deemed necessary. Here we discuss the literature review of intradural extramedullary tumors in a glance and clinical presentation, symptomatology, and prognosis of 40 extramedullary intradural tumor cases that we have operated on in a span of 15 years. Out of these 40 cases, majority were schwannomas. The incidence of schwannoma was found to be higher in the 30-50 age group. 5 cases of meningiomas, 5 cases of cystic schwannomas and 1 each of intradural metastasis, paraganglinoma, AV malformation, ependymoma, cellular schwannoma, intradural hematoma and intradural lipoma with tethering. All cases had postoperative improvement in neurological status to normalcy.

Keywords: Spinal tumors, Intradural extramedullary tumors, schwannomas, meningiomas, cystic schwannomas, intradural metastasis, paraganglinoma, AV malformation, ependymoma, cellular schwannoma, intradural hematoma, intradural lipoma , symptomatology, MRI, prognosis


References

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How to Cite this Article: Pillai S S, M Harishankar. Intradural Extramedullary Spinal Tumors – A Review of Modern Diagnostic and Treatment Options and a Report of a Series of 40 Cases. Kerala Journal of Orthopaedics Jan-June 2019; 32(1): 41-45.

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