Removal of Intradural Extramedullary Schwannoma at Lumbar Level by Doing Laminoplasty in Paediatric Patient- A Case Report and Review of Literature

Intradural Extramedullary tumour of thoracolumbar spine has been mainly treated with laminectomy till date. Other approach has been of treating this pathology by doing laminoplasty. Objective of this case presentation is that laminoplasty is better option for IDEM in selected cases. Laminectomy has been associated with many complications which can be avoided by doing laminoplasty such as postoperative spinal instability, epidural fibro¬sis, kyphotic deformity, excessive blood loss, hematoma invasion, progressive myelopathy, persistent back pain and prolonged hospital stay. So laminoplasty has clearly advantage compared to laminectomy in preserving posterior arch of the spine. Revision surgery is also easier when primary surgery has been done by laminoplasty. In our case of 13-year-old boy having Intradural Extramedullary Schwannoma at L3 level, he was treated with flipping laminoplasty and tumour excision. At final follow up he was having complete clinical recovery and fully healed laminoplasty assessed with CT scan without any recurrence of tumour or any spinal deformity. It proves our purpose of doing laminoplasty with better outcome compared to laminectomy. Keywords: Laminoplasty; Laminectomy; Intradural Extramedullary; Spinal Cord Tumour.

Spinal Tumor Surgery- Our Experiences of 35 Cases in a Peripheral Hospital in Bangladesh

Introduction: Surgical outcome of spinal tumour varies depending on a number of factors such as: site of the tumour, compression within the spinal canal, the histological characteristics of the tumour, the neurological progression and initial response to corticosteroid therapy, patient’s age, comorbidity, tumour extension, involvement of neighboring structures and organs etc. Materials & Methods: The 35 patients with spinal tumour underwent surgery by our team in 10 years (January 2009 - December 2018) were reviewed retrospectively. Results: Analysis of the surgical outcome of our spinal tumour patients was done on different variables like age, sex, presenting symptoms, neuroimaging, comorbidities etc. The aim of surgery was decompression of the spinal cord, total removal of the tumour when possible and spinal stabilization when needed. Out of our 35 patients with spinal tumour, extradural tumour comprises 8, intradural extramedullary tumour 25 and intramedullary tumour 2. Conclusion: The aim of this study is to analyze the data to made conclusion for more effective strategy as per site, size, type, resectibility and histological variety to establish and effective treatment protocol and prevention of per-operative and post-operative complications. Intradural extramedullary tumour can be radically resected with no mortality and minimal peri-operative morbidity. But resection of intramedullary spinal tumour is difficult, hazardous and usually incomplete, so needs much more skilled and meticulous surgical hands. Medicine Today 2021 Vol.33(1): 38-41

Synovial Sarcoma of the Spine: A Rare 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.

Surgical Outcome of Spinal Tumour: Our Experience in Dhaka Medical College & Hospital

Introduction: Surgical outcome of spinal tumour varies depending on a number of factors such as: site of tumour, compression within the spinal canal, the histological characteristics of tumour, the neurological progression and initial response to corticosteroid therapy, patient’s age, comorbidity, tumour extension, involvement of neighboring structures and organs etc. Materials & Methods: The 86 patients with spinal tumour underwent surgery by our team in 7 years (2011-2018) were reviewed retrospectively. Discussion: Analysis of the surgical outcome of our spinal tumour patients was done on different variables like age, sex, presenting symptoms, neuroimaging, comorbidities etc. The aim of surgery was decompression of the spinal cord, total removal of the tumour when possible and spinal stabilization when needed. Out of our 86 patients with spinal tumour, extradural tumour comprises 18, intradural tumour 56 and intramedullary tumour 12. Conclusion: The aim of this study is to analyze the data to made conclusion for more effective strategy as per site, size, type, resectibility and histological variety to establish and effective treatment protocol and prevention of per-operative and post-operative complications. Intradural extramedullary tumour can be radically resected with no mortality and minimal peri-operative morbidity. But resection of intramedullary spinal tumour is difficult, hazardous and usually incomplete, so needs much more skilled and meticulous surgical hands. Bang. J Neurosurgery 2019; 8(2): 63-67

MODIFIED LAMINOPLASTY AFTER EXCISION OF CERVICAL SCHWANNOMA WITH LARGE EXTRAVERTEBRAL EXTENSION

Tumour excision and laminoplasty are commonly performed as surgical treatment of extra vertebral extension of cervical schwannoma. It is worth knowing that the conventional technique of multilevel laminectomy may hinder younger patients in the long-term. This article reports a 30-year old man with an intradural-extramedullary tumour which extended from C4 to T1 that underwent modified laminoplasty. This modified technique is preferable in maintaining the anteroposterior diameter of spinal canal as well as reducing the displacement of guttered laminae