11 Thoracic spineintradural extramedullary lesions withinIntradural extramedullary lesions within thoracic spineminimally invasive resection ofMinimally Invasive Resection of Intradural Extramedullary Lesions within the Thoracic Spine

Capillary hemangiomas are benign tumors found in the skin and soft tissues in younger people. They occur in the central nervous system only rarely, and intradural occurrence is extremely rare. We report here a 60-year-old man presenting with thoracic girdle pain and progressive gait disturbance. Magnetic resonance images of the thoracic spine showed a12×8×20 mm, well-defined intradural mass at the T2 level, compressing the spinal cord laterally. Relative to the spinal cord, the mass was hypo- to isointense on T1-weighted images and relatively hyperintense on T2-weighted images, with strong enhancement on contrast-enhanced T1-weighted images. The patient underwent T1-2 hemilaminectomy with resection of the intradural extramedullary tumor, which showed characteristics of a capillary hemangioma on histologic examination. The patient’s symptoms improved following the surgery and no clinical or radiological evidence of recurrence was noted at the 2-year follow-up. We present this case with a review of the literature, highlighting features for differential diagnosis.

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Anatomic Basis for Minimally Invasive Resection of Intradural Extramedullary Lesions in Thoracic Spine

World Neurosurgery ◽

10.1016/j.wneu.2017.10.078 ◽

2018 ◽

Vol 109 ◽

pp. e770-e777 ◽

Cited By ~ 3

Author(s):

Luis M. Tumialán ◽

Nicholas Theodore ◽

Mohan Narayanan ◽

Frederick F. Marciano ◽

Peter Nakaji

Keyword(s):

Minimally Invasive ◽

Thoracic Spine ◽

Anatomic Basis ◽

Intradural Extramedullary

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Intradural Extramedullary Tuberculoma of the Thoracic Spine: Paradoxical Response to Antituberculous Therapy

Internal Medicine ◽

10.2169/internalmedicine.47.0839 ◽

2008 ◽

Vol 47 (8) ◽

pp. 797-798 ◽

Cited By ~ 10

Author(s):

Hirokatsu Takahashi ◽

Shoichi Ito ◽

Shigeyuki Kojima ◽

Takaaki Tanno ◽

Takamichi Hattori

Keyword(s):

Thoracic Spine ◽

Antituberculous Therapy ◽

Paradoxical Response ◽

Intradural Extramedullary

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Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience

Journal of Neurosurgery Spine ◽

10.3171/2013.9.spine12913 ◽

2013 ◽

Vol 19 (6) ◽

pp. 701-707 ◽

Cited By ~ 19

Author(s):

Ankit I. Mehta ◽

Owoicho Adogwa ◽

Isaac O. Karikari ◽

Paul Thompson ◽

Terence Verla ◽

...

Keyword(s):

Thoracic Spine ◽

Surgical Complications ◽

Neurological Deficits ◽

Spinal Tumors ◽

Anatomical Location ◽

Upper Thoracic Spine ◽

Csf Leakage ◽

Institutional Experience ◽

Intradural Extramedullary ◽

Upper Thoracic

Object Intradural extramedullary (IDEM) neoplasms are uncommon lesions that can pose a challenge for resection. Numerous factors affect the resectability and ultimately the outcome of these lesions. The authors report their 10-year institutional experience with the resection of IDEM neoplasms, focusing on the effect of location on surgical outcomes. Methods The authors performed a retrospective review of 96 consecutive patients who presented with a cervical and/or thoracic IDEM tumor that was resected between February 2000 and July 2009. All patients underwent MRI, and the axial location of the tumor was categorized as anterior, posterior, or lateral. Postoperative complications were assessed, as was neurological status at the patient's last follow-up clinic visit. Major complications assessed included CSF leakage requiring lumbar drainage, reexploration for epidural hematoma, and major postoperative neurological deficits. Results The mean ± SD age at presentation was 51.16 ± 17.87 years. Major surgical approach–related complications occurred in 15% of patients. Major non–approach related surgical complications occurred in 7.1% of patients, while minor complications occurred in 14.2% of patients. Postoperative neurological deficits occurred most commonly in the thoracic spine between T-1 and T-8. Based on axial spinal cord location, the surgery-related complications rates for all anterior tumors (n = 12) was 41.6%, whereas that for all lateral tumors (n = 69) was 4.4% and that for all posteriorly located tumors (n = 17) was 0%. Conclusions Spinal IDEM tumors that are anteriorly located in the upper thoracic spine were found to have the highest rate of surgery-related complications and postoperative neurological deficits. This finding may be associated with the unforgiving anatomy of the upper thoracic spine in which there is a higher cord-to-canal ratio and a tenuous vascular supply.

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Intradural extramedullary arachnoid cyst of the thoracic spine associated with cord compression

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2006.02.011 ◽

2007 ◽

Vol 14 (7) ◽

pp. 693-696 ◽

Cited By ~ 13

Author(s):

Markus Wenger ◽

Noemi Zobor ◽

Regula Markwalder ◽

Emanuel Vogt ◽

Thomas-Marc Markwalder

Keyword(s):

Arachnoid Cyst ◽

Thoracic Spine ◽

Cord Compression ◽

Intradural Extramedullary

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Intradural-extramedullary solitary fibrous tumor of the thoracic spine: A case report

Radiology Case Reports ◽

10.1016/j.radcr.2020.02.038 ◽

2020 ◽

Vol 15 (6) ◽

pp. 709-711 ◽

Cited By ~ 1

Author(s):

Beum Jin Kim ◽

Eunae Yoo ◽

Jinok Choi ◽

Soojung Kim

Keyword(s):

Case Report ◽

Thoracic Spine ◽

Solitary Fibrous Tumor ◽

Intradural Extramedullary ◽

Fibrous Tumor

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Shape Factor of the Spinal Cord: A Possible Predictor of Surgical Outcome for Intradural Extramedullary Spinal Tumors in the Thoracic Spine

Global Spine Journal ◽

10.1177/2192568220982571 ◽

2021 ◽

pp. 219256822098257

Author(s):

Yoshihiro Matsumoto ◽

Hirokazu Saiwai ◽

Keiichiro Iida ◽

Seiji Okada ◽

Makoto Endo ◽

...

Keyword(s):

Spinal Cord ◽

Thoracic Spine ◽

Surgical Outcome ◽

Shape Factor ◽

Univariate Analysis ◽

Quantitative Information ◽

Spinal Tumors ◽

Cross Sectional ◽

Japanese Orthopedic Association ◽

Intradural Extramedullary

Study Design: Retrospective diagnostic analysis. Objectives: To establish a new predictor of surgical outcome after surgery for intradural extramedullary spinal tumor (IDEMT) in the thoracic spine, we introduced shape factor (SF), a mathematical description of the morphology of the spinal cord. SF was calculated by dividing object area by the square of perimeter. Materials and Methods: Forty-three consecutive patients with IDEMT, detected by magnetic resonance imaging at the thoracic level with myelopathic signs, were included. Preoperative transverse cross-sectional area (CSA) and perimeter of the spinal cord (perimeter) at the level of maximal compression were measured. SF was calculated as 4π × CSA/(perimeter)2. The association between clinicoradiological factors and surgical outcome of IDEMT was statistically analyzed. Results: Mean CSA, perimeter, and SF were 27.8 ± 15.8 mm2, 28.8 ± 6.1 mm, and 0.385 ± 0.14, respectively. A histogram distribution revealed that perimeter and SF, but not CSA, fit the normal distribution. The patients were subdivided into 2 groups according to postoperative modified Japanese Orthopedic Association Score (mJOA). [group F (favorable): n = 32, mJOA ≥ 9; group UF (unfavorable): n = 11, mJOA < 9). Group UF had significantly lower mean CSA and SF. In univariate analysis of possible predictive factors for IDEMT surgery, greater age, lower preoperative mJOA, and lower SF were significantly associated with unfavorable outcome. In multivariate analysis, lower SF was the only significant predictor of postoperative outcome (odds ratio = 2.66, 95% CI 1.10–6.39, p = 0.0115). Conclusion: Measurements of CSA and perimeter, followed by calculation of SF, may provide valuable quantitative information for the outcome of surgery for IDEMT.

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