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The Surgical Treatment for Spinal Intradural Extramedullary Tumors

BACKGROUND: We 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. METHODS: The spinal IDEM tumor patients (11 cases) who had been treated by surgical excisi...

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Autores principales: Ahn, Dong-Ki, Park, Hoon-Seok, Choi, Dae-Jung, Kim, Kwan-Soo, Kim, Tae-Woo, Park, Soon-Youl
Formato: Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766751/
https://www.ncbi.nlm.nih.gov/pubmed/19885053
http://dx.doi.org/10.4055/cios.2009.1.3.165
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author Ahn, Dong-Ki
Park, Hoon-Seok
Choi, Dae-Jung
Kim, Kwan-Soo
Kim, Tae-Woo
Park, Soon-Youl
author_facet Ahn, Dong-Ki
Park, Hoon-Seok
Choi, Dae-Jung
Kim, Kwan-Soo
Kim, Tae-Woo
Park, Soon-Youl
author_sort Ahn, Dong-Ki
collection PubMed
description BACKGROUND: We 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. METHODS: The 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. RESULTS: The 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; r(2) = 0.75, p = 0.010, Nurick's grade; r(2) = 0.69, p = 0.019). One case of schwannoma recurred. CONCLUSIONS: The 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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spelling pubmed-27667512009-11-02 The Surgical Treatment for Spinal Intradural Extramedullary Tumors Ahn, Dong-Ki Park, Hoon-Seok Choi, Dae-Jung Kim, Kwan-Soo Kim, Tae-Woo Park, Soon-Youl Clin Orthop Surg Original Article BACKGROUND: We 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. METHODS: The 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. RESULTS: The 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; r(2) = 0.75, p = 0.010, Nurick's grade; r(2) = 0.69, p = 0.019). One case of schwannoma recurred. CONCLUSIONS: The 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. The Korean Orthopaedic Association 2009-09 2009-08-17 /pmc/articles/PMC2766751/ /pubmed/19885053 http://dx.doi.org/10.4055/cios.2009.1.3.165 Text en Copyright © 2009 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ahn, Dong-Ki
Park, Hoon-Seok
Choi, Dae-Jung
Kim, Kwan-Soo
Kim, Tae-Woo
Park, Soon-Youl
The Surgical Treatment for Spinal Intradural Extramedullary Tumors
title The Surgical Treatment for Spinal Intradural Extramedullary Tumors
title_full The Surgical Treatment for Spinal Intradural Extramedullary Tumors
title_fullStr The Surgical Treatment for Spinal Intradural Extramedullary Tumors
title_full_unstemmed The Surgical Treatment for Spinal Intradural Extramedullary Tumors
title_short The Surgical Treatment for Spinal Intradural Extramedullary Tumors
title_sort surgical treatment for spinal intradural extramedullary tumors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766751/
https://www.ncbi.nlm.nih.gov/pubmed/19885053
http://dx.doi.org/10.4055/cios.2009.1.3.165
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