scholarly journals Unilateral laminectomy approach for total resection of intradural extramedullary spinal tumor

2019 ◽  
Vol 2 (2) ◽  
pp. 23-26
Author(s):  
Steven Awyono ◽  
Putu Eka Mardhika ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Akbar Wido ◽  
Hizkia Lumban Gaol ◽  
...  
Keyword(s):  
Recovery Time ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Fast Recovery ◽  
Spinal Cord Tumors ◽  
Total Resection ◽  
Central Nervous System Neoplasm ◽  
The Central Nervous System ◽  
Intradural Extramedullary ◽  
Care Period

Spinal tumors found in about 5-15% of the central nervous system neoplasm. Intradural-extramedullary spinal cord tumors are one of the types that usually managed with total laminectomy but with many postoperative complications. A 76-year-old woman with paraplegia caused by intradural-extramedullary intraspinal tumor at thoracic 4 level. For this patient, we performed unilateral laminectomy without any fusion or stabilization from the left side then we performed total excision of the tumor. The surgery was successfully done with fast improvement of patient condition, minimal pain after surgery, no blood transfusion needed, shorter intensive care period needed, and fast recovery time are the prominent things in this case. Three days after surgery, the patient’s motoric power already improved and then the patient is permitted to go home at the fifth day.

scholarly journals Spinal Cord Tumors—Our 5-Year Experience

2022 ◽  
Author(s):  
Manpreet S. Banga ◽  
B.V. Sandeep ◽  
Anantha Kishan ◽  
Arjun H. Dev ◽  
Rajesh B. Devabhakthuni
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Spinal Cord Tumors ◽  
Motor Weakness ◽  
Nerve Sheath Tumors ◽  
Intradural Extramedullary ◽  
The Common

Abstract Purpose To study the demography, incidence, symptoms, histopathology, postoperative complications and recovery in operated patients of spinal tumor. Overview of Literature Primary spinal cord tumors (SCT) are an uncommon entity. According to their location, spinal tumors are conveniently classified as extradural (ED) and intradural (ID), although some can be both inside and outside the dura. ID tumors can be intradural extramedullary (IDEM) or intramedullary SCT (IMSCT). Methods This is a retrospective study of 122 patients with spinal tumors who were surgically treated at the department of neurosurgery from 2014 to 2019 over a period of 5 years. Study Design This is a retrospective study. Results Out of 122 patients, there were 19 patients with ED tumor, 73 had IDEM, and 30 had IMSCT. As many as 73 patients were males and the rest of the 49 patients were females. Mean age at time of surgery was 40.79 years. The thoracic region of spinal canal was most frequently involved (64; 52.4%). The common clinical symptom was motor weakness (90 cases; 73.77%). Majority of the patients had symptoms for duration of 6 to 12 months. Schwannomas were the most common tumor among IDEM and extradural location. Ependymomas were the most common type in IMSCT. We observed significant improvement in most of our cases. Four patients deteriorated at 3 months follow- up. Conclusions There was a higher male:female ratio for all spinal cord tumors except meningiomas. There was also a higher proportion of nerve sheath tumors, and a lower proportion of meningiomas and neuroepithelial tumors. These results are similar to other studies from Asian countries.

scholarly journals Surgical Resection of a Cervical Intramedullary Schwannoma: A Case Report and Literature Review

2017 ◽  
Vol 3 (3) ◽  
pp. 151-158
Author(s):  
Peihai Zhang ◽  
Zhenxing Sun ◽  
Dan Yuan ◽  
Yaxing Sun ◽  
Zhanquan Zhang ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Spinal Tumor ◽  
Common Type ◽  
Preoperative Imaging ◽  
Tumor Type ◽  
Resonance Imaging ◽  
Surgical Experience ◽  
The Central Nervous System ◽  
Intradural Extramedullary ◽  
Intramedullary Schwannoma

Schwannomas are the most common type of spinal tumor, and they most commonly occur in intradural extramedullary locations. Intramedullary schwannomas of the central nervous system are very rare and are difficult to diagnose using preoperative imaging. Here, we report a rare, tiny cervical intramedullary schwannoma and review the literature regarding the clinical presentation, magnetic resonance imaging, pathology, and surgical experience associated with this rare tumor type.

scholarly journals Cervical meningioma resection including the inner dura through an open-door laminoplasty using hydroxyapatite spacers: A case report

2020 ◽  
Vol 11 ◽  
pp. 317
Author(s):  
Naohisa Miyakoshi ◽  
Michio Hongo ◽  
Yuji Kasukawa ◽  
Yoshinori Ishikawa ◽  
Daisuke Kudo ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Complete Resection ◽  
Csf Leak ◽  
Open Door ◽  
Spinal Cord Tumors ◽  
Total Resection ◽  
Watertight Closure ◽  
Intradural Extramedullary ◽  
The Ideal

Background: The ideal surgery for spinal cord tumors is complete resection to prevent recurrence. However, it should be accomplished safely/effectively without risking increased morbidity. Here, we report a cervical meningioma that was totally resected, including the inner dura, through a laminoplasty performed with hydroxyapatite (HA) spacers. Case Description: A 61-year-old Asian male presented with a symptomatic intradural extramedullary C4-C6 cervical meningioma. At surgery, this required resection of the inner dural layer through an open-door laminoplasty. Preservation of the outer dural layer facilitated a watertight closure and the avoidance of a postoperative cerebrospinal fluid (CSF) fistula. Notably, the laminoplasty utilized HA spacers which were magnetic resonance (MR) compatible allowing for future follow-up studies to evaluate for tumor recurrence. At 5-year follow-up, the tumor had not recurred, the patient was asymptomatic, and alignment was maintained. Conclusion: Gross total resection of an intradural extramedullary C4-C6 cervical meningioma was performed with removal of just the inner dural layer. Preservation of the outer dural layer allowed for a watertight closure and the avoidance of a postoperative CSF leak. Further, laminoplasty using HA spacers allowed for successful tumor resection, adequate fusion/stabilization, while not interfering with future MR studies (e.g., HA MR compatible).

scholarly journals Surgical outcome of intradural extramedullary spinal cord tumors - Our experience at a tertiary health care center

2020 ◽  
Vol 1 (2) ◽  
pp. 103-109
Author(s):  
Gyanendra Joshi ◽  
Binod Bijukachhe ◽  
Javed Ahmad Khan
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Clinical Results ◽  
Spinal Tumors ◽  
Myxopapillary Ependymoma ◽  
Spinal Cord Tumors ◽  
Vas Score ◽  
Post Surgery ◽  
Intradural Extramedullary

Introduction: To report the treatment results of 19 patients who underwent excision of intradural extramedullary (IDEM) spinal tumors. Materials & Methods:  This is a retrospective study. Patients’ records were retrieved from the electronic database of Grande International Hospital. There were 19 IDEM spinal tumors excised over a period of 6 years between January 2013 and August 2019 by a single surgeon. There were 11 (57.9%) males and 8 (42.1%) females with an average age of 48.37±21.87 years (range, 5-79 years). The mean postoperative follow-up period was 12.87±14.88 months (range, 15 days - 60 months). The histopathological findings, locations of the tumors, and clinical results were analyzed. Neurological findings were evaluated using ASIA grading system and pain was evaluated using VAS score. Results:  Histopathologically the tumors were: 8 meningioma (42.1%), 4 schwannoma (21.1%), 4 neurofibroma (21.1%), 1 dermoid cyst (5.3%), 1 lipoma (5.3%), and 1 myxopapillary ependymoma (5.3%). Tumor locations were: dorsal in 10 (52.6%), lumbar in 5 (26.3%), lumbosacral in 2 (10.5%), dorsolumbar in 1 (5.3%), and cervical in 1 (5.3%) patient. Neurologic status of 7 patients was normal and 12 had neurologic involvement with 3 patients having Cauda Equina Syndrome (CES) preoperatively. At the final follow-up, 3-grade, 2-grade and 1-grade improvement in ASIA score was observed in 1, 6 and 1 cases, respectively. There was no change in the ASIA grade in 1 case. All 3 cases of CES achieved full neural recovery. Preoperative VAS score was 9.21±1.08 and improved significantly to 0.74±1.62 after surgery. Neurological improvement was seen in 91.67% with complete recovery in 75% of the cases and not a single case deteriorated neurologically post-surgery. Conclusion:  Most intradural-extramedullary spinal cord tumors are mostly benign and good clinical results can be obtained when adequately treated with surgery.

scholarly journals Improved patient quality of life following intradural extramedullary spinal tumor resection

2016 ◽  
Vol 25 (5) ◽  
pp. 640-645 ◽  
Author(s):  
Matthew J. Viereck ◽  
George M. Ghobrial ◽  
Sara Beygi ◽  
James S. Harrop
Keyword(s):  
Quality Of Life ◽  
Clinical Symptoms ◽  
Tumor Resection ◽  
Spinal Tumor ◽  
Administrative Database ◽  
Spinal Tumors ◽  
Descriptive System ◽  
Intradural Extramedullary

OBJECTIVE Resection significantly improves the clinical symptoms and functional outcomes of patients with intradural extramedullary tumors. However, patient quality of life following resection has not been adequately investigated. The aim in this retrospective analysis of prospectively collected quality of life outcomes is to analyze the efficacy of resection of intradural extramedullary spinal tumors in terms of quality of life markers. METHODS A retrospective review of a single institutional neurosurgical administrative database was conducted to analyze clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) for pain, and the EQ-5D-3 L descriptive system were used to analyze quality of life preoperatively, less than 1 month postoperatively, 1–3 months postoperatively, 3–12 months postoperatively, and more than 12 months postoperatively. RESULTS The ODI scores increased perioperatively at the < 1-month follow-up from 36 preoperatively to 47. Relative to preoperative values, the ODI score decreased significantly at 1–3, 3–12, and > 12 months to 23, 17, and 20, respectively. VAS scores significantly decreased from 6.1 to 3.5, 2.4, 2.0, and 2.9 at the < 1-month, 1- to 3-, 3- to 12-, and > 12-month follow-ups, respectively. EQ-5D mobility significantly worsened at the < 1-month follow-up but improved at the 3- to 12-and > 12-month follow-ups. EQ-5D self-care significantly worsened at the < 1-month follow-up but significantly improved by the 3- to 12-month follow-up. EQ-5D usual activities improved at the 1- to 3-, 3- to 12-, and > 12-month follow-ups. EQ-5D pain and discomfort significantly improved at all follow-up points. EQ-5D anxiety and depression significantly improved at 1- to 3-month and 3- to 12-month follow-ups. CONCLUSIONS Resection of intradural extramedullary spine tumors appears to significantly improve patient quality of life by decreasing patient disability and pain and by improving each of the EQ-5D domains.

scholarly journals Histopathological Pattern of Spinal Tumor: Experience of 57 Cases in Bangladesh

2020 ◽  
Vol 10 (1) ◽  
pp. 27-32
Author(s):  
Md Shafiul Alam ◽  
Kaisar Haroon ◽  
Md Abdullah Alamgir ◽  
Kazi Hafiz Uddin ◽  
Md Farhad Ahmed ◽  
...  
Keyword(s):  
Tumor Tissue ◽  
Histopathological Examination ◽  
Spinal Tumor ◽  
Cross Sectional Study ◽  
Surgical Removal ◽  
Spinal Cord Tumors ◽  
Cross Sectional ◽  
Female Ratio ◽  
Study Population ◽  
Intradural Extramedullary

Background: Spinal cord tumors are presented with different histopathological pattern. Objective: The purpose of the present study was to see the different histopathological pattern of spinal tumor. Methodology: This descriptive cross sectional study was conducted in the Department of Neurosurgery at National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from January 2016 to December 2019 for a period of 04 (Four) years. Patients presented with spinal tumor were selected as study population. After surgical removal the spinal tumor, tissue was sent for histopathological examination to the Department of Neuropathology of the same institute. Result: A total number of 57 spinal tumor cases were recruited for this study. The male and female ratio was 1.34:1. Out of 57 spinal tumor mostly were located in the intradural extramedullary (IDEM) which was 39(68.4%) cases. Extradural and intramedullary were found in 7(12.3%) cases in each. Most of the spinal tumor were Schwannoma which was 28(49.1%) cases. Neurofibroma and meningioma were found in 6(10.5%) cases in each. Lipoma was found in 3(5.3%) cases. Ependymoma was found in 4(7.0%) cases. Conclusion: In conclusion Schwannoma is the most common variant of spinal tumor detected among the study population. Bang. J Neurosurgery 2020; 10(1): 27-32

scholarly journals Intradural Extramedullary Spinal Sarcoidosis Mimicking Meningioma

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Tokue Mieda ◽  
Junko Hirato ◽  
Hiromi Koshi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Rare Entity ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Total Resection ◽  
Case Presentation ◽  
Dural Tail Sign ◽  
Dural Tail ◽  
Intradural Extramedullary ◽  
Magnetic Resonance Imaging Mri

Background. Spinal sarcoidosis is a rare subgroup of neurosarcoidosis. Although most sarcoid lesions develop in the intramedullary compartment, intradural extramedullary (IDEM) spinal sarcoidosis is an extremely rare entity. Case Presentation. We herein report a case of IDEM spinal sarcoidosis mimicking a meningioma. A 32-year-old man presented to the hospital with clumsy hands and was unable to walk without assistance. Magnetic resonance imaging (MRI) of the cervical spine revealed a dural tail sign that is common in meningiomas. The patient underwent gross total resection. The pathological findings consisted with a sarcoid leision of the spinal cord. The patient’s myelopathy recovered after surgery. Conclusions. Physicians should be alert for the possibility of IDEM sarcoidosis mimicking a meningioma in the differential diagnosis of IDEM spinal cord tumors.

scholarly journals Analysis of 5-aminolevulinic acid–induced fluorescence in 55 different spinal tumors

2014 ◽  
Vol 36 (2) ◽  
pp. E11 ◽  
Author(s):  
Matthias Millesi ◽  
Barbara Kiesel ◽  
Adelheid Woehrer ◽  
Johannes A. Hainfellner ◽  
Klaus Novak ◽  
...  
Keyword(s):  
Light Microscopy ◽  
White Light ◽  
Aminolevulinic Acid ◽  
Protoporphyrin Ix ◽  
Spinal Tumor ◽  
Cns Tumors ◽  
Spinal Tumors ◽  
Total Resection ◽  
Intramedullary Tumors ◽  
Who Grade

Object Subtotal resection (STR) of spinal tumors can result in tumor recurrence. Currently, no clinically reliable marker is available for intraoperative visualization of spinal tumor tissue. Protoporphyrin IX (PpIX) fluorescence induced by 5-aminolevulinic acid (5-ALA) is capable of visualizing malignant gliomas. Fluorescence-guided resections of malignant cerebral gliomas using 5-ALA have resulted in an increased rate of complete tumor removal. Recently, the application of 5-ALA has also been described in the first cases of spinal tumors. Therefore, the aim of this observational study was to systematically investigate 5-ALA–induced fluorescence characteristics in different spinal tumor entities. Methods Three hours before the induction of anesthesia, 5-ALA was administered to patients with different intra- and extradural spinal tumors. In all patients a neurosurgical resection or biopsy of the spinal tumor was performed under conventional white-light microscopy. During each surgery, the presence of PpIX fluorescence was additionally assessed using a modified neurosurgical microscope. At the end of an assumed gross-total resection (GTR) under white-light microscopy, a final inspection of the surgical cavity of fluorescing intramedullary tumors was performed to look for any remaining fluorescing foci. Histopathological tumor diagnosis was established according to the current WHO classification. Results Fifty-two patients with 55 spinal tumors were included in this study. Resection was performed in 50 of 55 cases, whereas 5 of 55 cases underwent biopsy. Gross-total resection was achieved in 37 cases, STR in 5, and partial resection in 8 cases. Protoporphyrin IX fluorescence was visible in 30 (55%) of 55 cases, but not in 25 (45%) of 55 cases. Positive PpIX fluorescence was mainly detected in ependymomas (12 of 12), meningiomas (12 of 12), hemangiopericytomas (3 of 3), and in drop metastases of primary CNS tumors (2 of 2). In contrast, none of the neurinomas (8 of 8), carcinoma metastases (5 of 5), and primary spinal gliomas (3 of 3; 1 pilocytic astrocytoma, 1 WHO Grade II astrocytoma, 1 WHO Grade III anaplastic oligoastrocytoma) revealed PpIX fluorescence. It is notable that residual fluorescing tumor foci were detected and subsequently resected in 4 of 8 intramedullary ependymomas despite assumed GTR under white-light microscopy. Conclusions In this study, 5-ALA–PpIX fluorescence was observed in spinal tumors, especially ependymomas, meningiomas, hemangiopericytomas, and drop metastases of primary CNS tumors. In cases of intramedullary tumors, 5-ALA–induced PpIX fluorescence is a useful tool for the detection of potential residual tumor foci.

scholarly journals Clinical outcome of intradural extramedullary spinal cord tumors: A single-center retrospective analytical study

2021 ◽  
Vol 12 ◽  
pp. 145
Author(s):  
Pratik Patel ◽  
Dhanish Mehendiratta ◽  
Vivek Bhambhu ◽  
Samir Dalvie
Keyword(s):  
Spinal Cord ◽  
Clinical Outcome ◽  
Surgical Intervention ◽  
Spinal Tumors ◽  
Cerebrospinal Fluid Leakage ◽  
Karnofsky Performance Score ◽  
Spinal Cord Tumors ◽  
Mri Scans ◽  
Intradural Extramedullary ◽  
Acute Neurological Deterioration

Background: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two-thirds of largely benign intraspinal neoplasms. They occasionally present with acute neurological deterioration warranting emergent surgical intervention. Methods: Here, we reviewed a series of 31 patients with intradural extramedullary spinal tumors who underwent surgery from 2012 to 2019. Patients averaged 50.8 years of age, and there were 16 males and 15 females. Patients were followed for a minimum of 1 year. Multiple clinical outcome variables were studied (e.g., Karnofsky Performance Score [KPS], visual analog scale (VAS), and Frankel grade). Results: The majority of IESCT tumors were found in the thoracic spine 18 (58.06%) followed by the lumbar 8 (25.80%), cervical 1 (3.22%), and combined junctional tumors 4 (12.90%) (cervicothoracic-02 and thoracolumbar-02). Histopathological diagnoses included schwannomas-16 (51.61%), meningiomas-11 (35.48%), lipomas-2 (6.45%), hemangiomas-1 (3.22), and ependymomas-01 (03.22%). The VAS score was reduced in all cases, while KPS and Frankel grades were significantly improved. Complications included cerebrospinal fluid leakage, new/residual paresthesias, and tumor recurrence (12.50%). Conclusion: Most intradural extramedullary tumors are benign and are readily diagnosed utilizing MRI scans. Notably, good functional outcomes follow surgical intervention.

Spinal Cord Tumors

2021 ◽  
pp. 949-955
Author(s):  
I. Darin Carabenciov ◽  
Joon H. Uhm
Keyword(s):  
Spinal Cord ◽  
Clinical Characteristics ◽  
Cauda Equina ◽  
Spinal Tumors ◽  
Tumor Type ◽  
Spinal Cord Tumors ◽  
Imaging Characteristics ◽  
Anatomical Compartment ◽  
Intradural Extramedullary

Spinal tumors can be broadly classified on the basis of the anatomical compartment they occupy. These tumors can be intramedullary, intradural extramedullary, or extradural. Regardless of location, significant neurologic morbidity can occur as a result of their effects on the spinal cord or the cauda equina, or both. This chapter summarizes the pathophysiologic factors, clinical characteristics, imaging characteristics, and treatment of each tumor type.

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