To Analyze Outcome of Spinal Intradural Extramedullary Tumors. Experience of Lady Reading Hospital Department of Neurosurgery B unit

Abstract

Background: Spinal tumors classification is extradural, intradural extramedullary (IDEM), or intradural intramedullary. IDEM tumors are  rare, occurring in 5 to 10 per million people. Objective: To analyze outcome of spinal intradural extramedullary tumors. Material & Methods: This is retrospective descriptive study. This study was conducted in the department of neurosurgery unit B, MTI, LRH from 1st July 2013 to 30th December 2016. All spinal IDEM tumors were included. Metastasis, carries spine, intramedullary tumors were excluded. Patient history and clinical examination findings were noted from hospital record. All patient preoperative and postoperative MRI spine record collected. Biopsies were done in all cases. Post-operative complications and functional outcome were noted from patient record and follow-up.  All data were analyzed with SPSS version 20 and presented in tables and charts. Results: Total numbers of cases were 17, Male 11(64.71%) and female 6(35.29%), age ranges from  18 to 61 year mean 41 ±13 years. Schwannomas was found in 10 (58.83%) cases, meningioma in 6 (35.29%) cases and myxopapillary ependymoma of filum terminale in 1 (5.88%) case. Cervical tumors were 5(29.41%), thoracic 8(47.06%) and lumbo-sacral spine in 4(23.53%) cases.  Posterior approach was done in all cases. Nurick's grade improvement was noted in all cases from 3.0 ± 1.3 to 2.0 ± 0.0 (p = 0.005). Conclusions: The commonest symptom was localized pain at the site of lesion. Thoracic spine was commonest site. Shwannoma is commonest patholgy. Early diagnosis, small size of the tumor and early surgery has better functional outcome. Keywords: Intradural extra medullary tumor, Nurick grade, Shwannoma, MRI spine