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Delay in diagnosis of primary intradural spinal cord tumors

BACKGROUND: It has been our impression in recent years that there is a significant delay in diagnosis (DID) of patients in Israel harboring intradural spinal cord tumors (IDSCTs). DID can lead to irreversible deficits and unnecessary suffering. Our goal was to identify the incidence and the specific...

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Autores principales: Segal, David, Lidar, Zvi, Corn, Akiva, Constantini, Shlomi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356987/
https://www.ncbi.nlm.nih.gov/pubmed/22629489
http://dx.doi.org/10.4103/2152-7806.96075
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author Segal, David
Lidar, Zvi
Corn, Akiva
Constantini, Shlomi
author_facet Segal, David
Lidar, Zvi
Corn, Akiva
Constantini, Shlomi
author_sort Segal, David
collection PubMed
description BACKGROUND: It has been our impression in recent years that there is a significant delay in diagnosis (DID) of patients in Israel harboring intradural spinal cord tumors (IDSCTs). DID can lead to irreversible deficits and unnecessary suffering. Our goal was to identify the incidence and the specific reasons for DID of IDSCTs in patients operated upon at our institution. METHODS: A retrospective record review, with additional telephone survey, of 101 patients operated upon at our institute between the years 1996 and 2009 was conducted. The patients who were not diagnosed locally and those who were diagnosed during routine spinal imaging studies as part of their basic disease check-up were excluded. Accordingly, neurofibromatosis and medical tourist patients were excluded. RESULTS: The clinical presentation of IDSCTs in our study was similar to the descriptions given in previous reports. The average age was 41.9 ± 23.3 years. Most tumors were ependymomas, astrocytomas, and schwannomas. The most common symptoms were motor or sensory disturbance, back pain, walking disturbance, and sphincter control deficit. The median time to diagnosis was 12.0 ± 37.0 months (range 3 days to 20 years). We found DID in 82.2% of the cases. 62.4% of the cases were defined as “unreasonable delay.” The most common reasons for DID were “classical symptoms with a wrong diagnosis” and “delayed imaging.” CONCLUSIONS: Based on the results of this study, the incidence of unreasonable delays in diagnosis of primary IDSCTs in Israel is very high. In order to shorten the time to diagnosis, primary and secondary care physicians need to increase their awareness of symptoms that may be associated with these lesions. We hereby offer feedback for care providers, relevant to the diagnostic workup of these patients. Such a feedback must be delivered by neurosurgeons to the community they are serving.
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spelling pubmed-33569872012-05-24 Delay in diagnosis of primary intradural spinal cord tumors Segal, David Lidar, Zvi Corn, Akiva Constantini, Shlomi Surg Neurol Int Original Article BACKGROUND: It has been our impression in recent years that there is a significant delay in diagnosis (DID) of patients in Israel harboring intradural spinal cord tumors (IDSCTs). DID can lead to irreversible deficits and unnecessary suffering. Our goal was to identify the incidence and the specific reasons for DID of IDSCTs in patients operated upon at our institution. METHODS: A retrospective record review, with additional telephone survey, of 101 patients operated upon at our institute between the years 1996 and 2009 was conducted. The patients who were not diagnosed locally and those who were diagnosed during routine spinal imaging studies as part of their basic disease check-up were excluded. Accordingly, neurofibromatosis and medical tourist patients were excluded. RESULTS: The clinical presentation of IDSCTs in our study was similar to the descriptions given in previous reports. The average age was 41.9 ± 23.3 years. Most tumors were ependymomas, astrocytomas, and schwannomas. The most common symptoms were motor or sensory disturbance, back pain, walking disturbance, and sphincter control deficit. The median time to diagnosis was 12.0 ± 37.0 months (range 3 days to 20 years). We found DID in 82.2% of the cases. 62.4% of the cases were defined as “unreasonable delay.” The most common reasons for DID were “classical symptoms with a wrong diagnosis” and “delayed imaging.” CONCLUSIONS: Based on the results of this study, the incidence of unreasonable delays in diagnosis of primary IDSCTs in Israel is very high. In order to shorten the time to diagnosis, primary and secondary care physicians need to increase their awareness of symptoms that may be associated with these lesions. We hereby offer feedback for care providers, relevant to the diagnostic workup of these patients. Such a feedback must be delivered by neurosurgeons to the community they are serving. Medknow Publications & Media Pvt Ltd 2012-05-14 /pmc/articles/PMC3356987/ /pubmed/22629489 http://dx.doi.org/10.4103/2152-7806.96075 Text en Copyright: © 2012 Segal D. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Segal, David
Lidar, Zvi
Corn, Akiva
Constantini, Shlomi
Delay in diagnosis of primary intradural spinal cord tumors
title Delay in diagnosis of primary intradural spinal cord tumors
title_full Delay in diagnosis of primary intradural spinal cord tumors
title_fullStr Delay in diagnosis of primary intradural spinal cord tumors
title_full_unstemmed Delay in diagnosis of primary intradural spinal cord tumors
title_short Delay in diagnosis of primary intradural spinal cord tumors
title_sort delay in diagnosis of primary intradural spinal cord tumors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356987/
https://www.ncbi.nlm.nih.gov/pubmed/22629489
http://dx.doi.org/10.4103/2152-7806.96075
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