scholarly journals Clinical profile, management and surgical outcome of spinal cord tumors

2021 ◽  
Vol 8 (10) ◽  
pp. 3013
Author(s):  
Shobhit Chhabra ◽  
Bhagirath More ◽  
Deepak Ranade ◽  
Sarang Gotecha ◽  
Prashant Punia ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Excision ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Cervical Cord ◽  
Subtotal Resection ◽  
Histopathological Diagnosis ◽  
Tumor Type ◽  
Spinal Cord Tumors ◽  
Significant Drop

Background: Spinal cord tumors can result in dramatic neurological and functional disabilities in the patients. We aimed to know the incidence of different types of spinal tumors and correlation between clinical presentation and pathological findings and compare outcomes of these tumors postoperatively.Methods: A total of 50 patients were included in the study group. After a thorough clinical evaluation, patients were subjected to a magnetic resonance imaging (MRI) and then surgery. They were described on the basis of age, sex, location of the tumor, type of the tumor, symptoms, histopathological type, surgical resection and complications.Results: Study included 29 males and 21 females and their age ranged from 5 years to 70 years. Out of the 50 patients, 39 had intradural and 11 had extradural spinal tumors. Amongst the 39 intradural tumors, 27 were extramedullary and 12 were intramedullary in location. A predilection towards the thoracic region (44%) was seen followed by the cervical cord. The tumors were excised completely in 68% of the patients while subtotal resection was done in 18% and near total resection in 14% patients. There was significant drop in VAS score and improvement in McCormicks score at 3 months of follow up.Conclusions: Based on this study it could be suggested that surgical excision and decompression should be attempted in all patients of intradural spinal tumor fit to undergo the procedure, as it not only helps in reaching a definitive histopathological diagnosis but also achieves neurological improvement in most patients without causing significant morbidity and mortality.

scholarly journals Synovial Sarcoma of the Spine: A Rare Intradural Extramedullary Tumour

2020 ◽  
Vol 17 (3) ◽  
pp. 45-49
Author(s):  
Ajay Sebastian Carvalho ◽  
Kishan Kumar Yadav ◽  
Vijay Kumar Gupta
Keyword(s):  
Synovial Sarcoma ◽  
Soft Tissue Sarcomas ◽  
Surgical Excision ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Histopathological Diagnosis ◽  
Dumbbell Tumor ◽  
Imaging Characteristics ◽  
The Right ◽  
Intradural Extramedullary Tumour

Synovial sarcoma (SS) accounts for 5- 10% of all adult soft-tissue sarcomas and only 5% arises in the spine. It presents like any other spinal tumor, namely axial pain with symptoms due to neural compression. Imaging findings can also be similar to any other benign spinal tumor. We present a 43-year-old male who presented with symptoms of radiculopathy and neural compression and imaging revealed a dumbbell tumor at C6 to D1 with transforaminal and paraspinal extension on the right side. After surgical excision the histopathology revealed a rare synovial sarcoma of the spine. Synovial sarcoma of the spine though rare, are difficult to differentiate based on their presentation and imaging characteristics from benign spinal tumors. However, subtle findings on imaging and a pre-operative biopsy may aid in performing a more definitive surgery upfront rather than a re-do surgery after the histopathological diagnosis.  

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.

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.

scholarly journals Does preoperative transarterial embolization decrease blood loss during spine tumor surgery?

2015 ◽  
Vol 21 (1) ◽  
pp. 129-135 ◽  
Author(s):  
Zhihong Qiao ◽  
Ningyang Jia ◽  
Qian He
Keyword(s):  
Blood Loss ◽  
Transarterial Embolization ◽  
Surgical Excision ◽  
Spinal Tumor ◽  
Gelatin Sponge ◽  
Spinal Tumors ◽  
Control Group ◽  
Time Interval ◽  
Estimated Blood Loss ◽  
Spine Tumor Surgery

This paper aimed to evaluate the effect of preoperative transarterial embolization (TAE) on estimated blood loss (EBL) during surgical excision of the vertebral tumors. Three hundred and forty-eight patients with spinal tumors were retrospectively analyzed. The preoperative TAE group consisted of 190 patients and the control group consisted of 158 patients. Gelatin sponge particles mixed withy contrast agent were used in the TAE group to embolize the tumor-feeding artery. The factors evaluated included: the time interval between embolism and surgery; the number of vertebrae involved by the tumor; pathological type of tumor; surgical approach; extent of excision and instrumental fixation. The time interval (P = 0.4669)between embolism and surgery had no significant correlation with EBL during surgery. The pathological diagnosis of vertebral tumor such as plasma cell myeloma, giant cell tumor, chondrosarcoma, hemangioma and metastasis had no significant correlation with EBL between the TAE group and control group during surgery, while the EBL of chordoma in the TAE group was significantly higher than that in the control group (p = 0.0254). The number of vertebrae involved (p = 0.4669, 0.6804, 0.6677), posterior approach (p = 0.3015), anterior approach (p = 0.2446), partial excision (p = 0.1911) and instrumental fixation (p = 0.1789) had no significant correlation with EBL during surgery between the TAE group and the control group. This study showed that preoperative TAE of the spinal tumor had no significant effect on intra-operative blood loss during surgical excision of the spinal tumor. In view of the risk of embolism, this method should be carefully considered.

scholarly journals Surgical treatment of primary intramedullary spinal cord tumors in adult patients

2008 ◽  
Vol 66 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Mario Augusto Taricco ◽  
Vinicius Monteiro de Paula Guirado ◽  
Ricardo Bragança de Vasconcellos Fontes ◽  
José Pindaro Pereira Plese
Keyword(s):  
Spinal Cord ◽  
Previous Treatment ◽  
Cervical Cord ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Treatment Protocols ◽  
Intramedullary Spinal Cord ◽  
Neurological Outcomes ◽  
Neurological Morbidity ◽  
Microsurgical Resection

BACKGROUND: Primary spinal cord intramedullary tumors are rare and present with insidious symptoms. Previous treatment protocols emphasized biopsy and radiation/chemotherapy but more aggressive protocols have emerged. OBJECTIVE: To report our experience. METHOD: Forty-eight patients were diagnosed with primary intramedullary tumors. The cervical cord was involved in 27% and thoracic in 42% of patients. Complete microsurgical removal was attempted whenever possible without added neurological morbidity. RESULTS: Complete resection was obtained in 33 (71%) patients. Neurological function remained stable or improved in 32 patients (66.7%). Ependymoma was the most frequent tumor (66.7%). CONCLUSION: Neurological outcome is superior in patients with subtle findings; aggressive microsurgical resection should be pursued with acceptable neurological outcomes.

scholarly journals Bilateral lower limb paralysis as initial symptom of neurofibromatosis type 2: A case report

2017 ◽  
Vol 4 (1) ◽  
pp. 24
Author(s):  
Mitsuru Yamagishi ◽  
Masaya Takahashi ◽  
Masahiro Nonaka ◽  
Yumiko Someno ◽  
Yoko Nakai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Lower Limb ◽  
Neurofibromatosis Type ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Thoracic Region ◽  
Lower Limb Paralysis ◽  
Bilateral Lower Limb ◽  
Tendon Reflexes

Neurofibromatosis type 2 (NF2) is an autosomal dominant disorder characterized by multiple tumors including schwannomas, meningiomas and ependymomas of the central nervous system. Although paresthesias, muscle weakness, muscle atrophy, and gait unsteadiness have been reported as clinical symptoms of spinal tumors, there are no reports of patients with NF2 who developed paralysis. A 7-year-old female consulted with our hospital because of sudden bilateral lower limb paralysis. She had not recognized the abnormalities, including paralysis, paraplegia and muscle weakness of bilateral lower limb before administration. Because of the aggravated bilateral patellar tendon reflexes, Achilles tendon reflexes, and the positive bilateral Babinski reflexes, a magnetic resonance imaging (MRI) of the spinal cord was performed. MRI revealed multiple spinal tumors in the cervical, thoracic, lumbar, and sacral regions. In particular, a 12 mm ×  33 mm spinal tumor was present in the thoracic region and was pressing against the spinal cord. Surgery was urgently performed to remove the spinal tumor in the thoracic region. Histopathological examination revealed that the tumor was a schwannoma. Gadolinium-enhanced MRI of the head was performed to explore the intra-cranial lesions: bilateral vestibular schwannomas and tumors in the left oculomotor nerve and right glossopharyngeal nerve were also discovered. Auditory brainstem response was performed to evaluate the bilateral VSs, and the results were normal. Nine months after the surgery, MRI of the head and spinal cord showed that her tumors had not increased in size. This represents the first reported case of NF2 complicated bilateral lower limb paralysis as initial neurological symptom.

scholarly journals Perineural invasion in intramedullary spinal cord metastasis

2020 ◽  
Vol 102 (5) ◽  
pp. e94-e96 ◽  
Author(s):  
N Jayakumar ◽  
H Ismail ◽  
S Athar ◽  
N Ashwood
Keyword(s):  
Spinal Cord ◽  
Brachial Plexus ◽  
Perineural Invasion ◽  
Surgical Excision ◽  
Cervical Cord ◽  
Limb Weakness ◽  
Intramedullary Spinal Cord ◽  
Spinal Cord Metastasis ◽  
Plexus Lesion ◽  
Intramedullary Spinal Cord Metastasis

A woman in her late sixties was referred to the orthopaedic clinic with progressive lower limb weakness and gait disturbance. She was known to have breast cancer with pre-existing infiltrative disease in the left brachial plexus. Magnetic resonance imaging of the spine revealed an intramedullary spinal cord metastasis in the lower cervical cord at C6–C7. She underwent surgical excision but died within six weeks of surgery. This rare case of an intramedullary spinal cord metastasis highlights the extremely poor prognosis in this condition as well as the possibility of perineural invasion into the spinal cord from the brachial plexus lesion. A detailed discussion of the literature on intramedullary spinal cord metastases is also presented.

scholarly journals Intradural extramedullary spinal cord tumours: A retrospective study of sur­ gical outcomes

2016 ◽  
Vol 9 (1) ◽  
pp. 11
Author(s):  
Md. Kamrul Ahsan ◽  
Md. Abdul Awwal ◽  
Shahidul Islam Khan ◽  
Md. Hamidul Haque ◽  
Naznin Zaman
Keyword(s):  
Spinal Cord ◽  
Surgical Excision ◽  
Clinical Results ◽  
Neurological Deterioration ◽  
Cerebrospinal Fluid Leakage ◽  
Myxopapillary Ependymoma ◽  
Histopathological Diagnosis ◽  
Preoperative Symptom ◽  
Intradural Extramedullary ◽  
Spinal Cord Tumours

<p><strong>Background:</strong> Intradural extramedullary spinal cord tumours (IESCT) accounts for approximately two thirds of all intraspinal neoplasm and are of important clinical consideration and surgery is the essence in cases with neurological deterioration.</p><p><strong>Objective:</strong> To share our experience on the outcome of surgical excision of intradural extramedullary spinal cord tumours. Methods: Results of 60 patients surgically treated intradural extramedullary spinal tumours between Octo­ber 2003 and October 2015 at Bangabandhu Sheikh Mujib Medical University and in our private settings, Dhaka, were analyzed retrospectively. There were 32 males, 28 females with an average age of 52.4 years (13-70 years) and followed up for at least a year. The preoperative symptom with duration, tumours location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade.</p><p><strong>Results:</strong> The tumours were located as, thoracic 32 (53.33%), lumbar 16 (26.67%), cervical 04 (6.67%), and junctional 08 (13.33%), CervicoThoracic-01, Thoracolumbar-07). The histopathological diagnosis included schwannoma 35 (58.33%), meningiomas 14 (23.33%), neurofbroma 4 (6.67%), arachnoid cyst and myxopapillary ependymoma 03 (05.00%) each and paraganglioma 01 (01.67%). The VAS score was reduced in all cases from 8.0 ± 1.2 to 1.2 ± 0.8 (p &lt; 0.003) and the Nurick's grade was improved in all cases from 3.0 ± 1.3 to 1.0 ± 0.0 (p &lt; 0.005). The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Complications included cerebrospinal fluid leakage, parasthesia, dependant bedsore 02 (3.33%) each and recurrence 03 (05.00%). and further neurological deterioration 1 (01.67%) case.</p><p><strong>Conclusion:</strong> lntradural extramedullary tumors detected by MRI are mostly benign and good clinical results can be obtained when treated surgi­cally. Aggressive surgical excision potentially minimizes neurologic morbidity and improved outcome. ­</p>

Nonenhancing tumors of the spinal cord

2007 ◽  
Vol 7 (4) ◽  
pp. 403-407 ◽  
Author(s):  
J. Bradley White ◽  
Gary M. Miller ◽  
Kennith F. Layton ◽  
William E. Krauss
Keyword(s):  
Spinal Cord ◽  
Common Finding ◽  
Subtotal Resection ◽  
Low Grade ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Intramedullary Spinal Cord ◽  
Tumor Invasiveness ◽  
The Central Nervous System ◽  
Tumor Types

Object Enhancement of pathological entities in the central nervous system is a common finding when the blood–brain barrier has been compromised. In the brain, the presence or absence of gadolinium enhancement is often an indicator of tumor invasiveness and/or grade. In the spinal cord, however, contrast enhancement has been shown in all tumor types, regardless of grade. In this study the authors explore the incidence of nonenhancing tumors of the spinal cord and the clinical course of patients with these lesions. Methods A retrospective analysis was conducted in which investigators examined the patterns of enhancement of histologically proven intramedullary spinal cord tumors that had been evaluated at the Mayo Clinic between 1998 and 2002. The tumors that did not enhance were the subject of this report. Results A total of 130 patients with intramedullary tumors were evaluated. Of those, 11 patients (9%) had tumors that did not enhance. Histologically, a majority of tumors were astrocytomas (eight low-grade and two high-grade lesions); one tumor was a subependymoma. Morphologically, most of the tumors were diffuse and none had associated cysts. Tumors spanned from two to seven levels and were located throughout the spinal cord (four cervical, three cervicothoracic, one thoracic, and three thoracolumbar). Biopsy procedures were performed in eight patients, subtotal resection was performed in two, and gross-total resection in one. After a mean follow-up period of 19 months, tumors remained stable in eight patients but progressed in three, two of whom died. Conclusions A number of intramedullary spinal cord tumors will not enhance after addition of contrast agents. The absence of enhancement does not imply the absence of tumor.

The development of techniques for resection of spinal cord tumors by Harvey W. Cushing

2005 ◽  
Vol 2 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Dennis D. Spencer ◽  
William E. Krauss
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Spinal Tumors ◽  
Spinal Cord Tumors ◽  
Content Type ◽  
Improved Outcomes ◽  
Peter Bent Brigham Hospital ◽  
Operative Notes ◽  
Natural Histories ◽  
Fine Print

✓ Harvey Cushing's refinement of Halsted's meticulous surgical techniques facilitated safe resection of intradural spinal tumors. Although Cushing focused his attention on brain tumors at the Peter Bent Brigham Hospital, his numerous contributions to the treatment of intradural spinal tumors include the description of these tumors' natural histories and their histological classifications. The application of his experienced intracranial techniques to the resection of spinal tumors improved outcomes. The authors review selected operative notes and sketches to demonstrate his technique in the excision of the spinal cord tumors.

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