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

Pre-operative spine embolisation for spinal tumors and metastases: 6 years experience at pusat perubatan universiti kebangsaan Malaysia.

Objective: Our aim is to determine the average intraoperative blood loss in patients who underwent pre-operative spinal tumour embolisation in PPUKM from 2010 until 2016 and to compare with other centres from literature review. Material And Methodology: 15 patients in PPUKM with spinal tumour and spinal metastatic disease underwent pre-operative embolisation before palliative spinal surgery between 2010 and 2016 in PPUKM. Intraoperative blood loss during palliative spinal surgery was documented obtaining the average and median blood loss. Secondary analyses were made on the amount of intraoperative blood loss in comparison to the embolisation materials, degree of embolisation completion, primary malignancy, level of spinal metastatic involvement and total operating time. Result: The average and median intraoperative blood loss during palliative spinal surgery were 1480mls and 1000mls respectively, which is comparable with other centre from literature review. Significant difference is noted in intraoperative blood loss between the different embolisation materials used (P<0.01). 10 patients had complete embolisation and 4 patients had incomplete embolisation with significant difference in terms of blood loss between these 2 groups with P value of <0.01. There was significant positive correlation between operating time and intra-operative blood loss, whereby the longer the operation, the higher the amount of blood loss. Conclusion: The average intraoperative blood loss in patients with pre-operative spinal tumour embolisation in PPUKM is comparable to other centres from literature review thus pre-operative tumour embolisation can reduce perioperative haemorrhage. However, larger study is needed to further analyse correlation between these factors in affecting intraoperative blood loss.

Spinal intramedullary cysticercosis mimicking spinal tumour

Neurocysticercosis is a relatively uncommon entity with even more rare spinal intramedullary variety. We present a case of cervico- dorsal intramedullary NCC mimicking spinal tumour with per operative finding mimicking abscess.

Surgical Outcome of Intradural-extra-medullarySpinal Tumour: 205 Our Experience in Dhaka Medical College & Hospital

Introduction: Surgical outcome of spinal tumours varies depending on a number of factors such as: site of tumour compression within the spinal canal, the histological characteristics of tumours, the neurological progression and initial response to corticosteroid therapy, patient’s age, comorbidity, tumour extension, involvement of neighbor structures and organs etc. Materials & Methods: The 46 patients with intradural extramedullary (IDEM) spinal tumour underwent surgery by our team in 7 years (2010-2017) were reviewed retrospectively. Discussion: Analysis of the surgical outcome of our spinal tumour patients was done on different variables like age, sex, presenting symptoms, neuro imaging, comorbidities etc. The aim of surgery was decompression of the spinal cord and total removal of the tumour. Conclusion: The aim of this study is to analyze the data to make conclusion for more effective strategy as per site, size, type, resectibility and histological variety to establish an effective treatment protocol and prevention of per-operative and post-operative complications. Intradural extramedullary tumor can be radically resected with no mortality and minimal peri-operative morbidity J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 205-208

Spinal tumours

Spinal tumours in adults, although usually presenting with pain and neurological dysfunction, are often incidental findings. For the spinal neurosurgeon, the range of pathologies, clinical presentations, and required surgical techniques included within the management of spinal neoplasia is vast, from benign lesions unchanged over a decade of observation to malignant disease that progresses over a few hours to paraplegia, and from the finest microsurgery to instrumentation over multiple spinal segments. Surgery has a key role to play in the management of many of these, both to decompress the neurological elements of the spine and, when necessary, to reconstruct the mechanical integrity of the spine. This chapter highlights some of the challenges facing the contemporary spinal tumour surgeon.

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

Magnetic Resonance Imaging Evaluation of Spinal Tumors and Its Comparison with Histopathological Findings

Objective: The objective of the study was to assess the diagnostic usefulness of MRI in evaluation of spinal tumors.Methodology: This cross-sectional study was carried out in Dhaka Medical College Hospital, Dhaka. The data was collected from July 2011 to June 2013 and total 51 patients were included in the study. Data was collected from MRI diagnosed spinal tumors who attended at Radiology and Imaging department of DMCH from OPD and indoor patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI for evaluation of spinal tumors were detected.Results: Out of 51 patients 26 (51%) was intradural extramedullary, 13 (25.5%) was extradural and 12 (23.5%) was intramedullary. Distribution of patients according to MR diagnosis. Among the 51 patients 40 were diagnosed spinal tumor and 11 were not spinal tumor by MRI. Among the 40 spinal tumuor diagnosed 12 (23.5%) were schwannoma, 02 (3.9%) were neuro fibroma, 11(21.6%) were meningioma, 07(13.7%) were ependymoma, 05(9.8%) were astrocytoma, 02(3.9%) were metastasis and 1 (2.0%) was osteoblastoma. Out of all cases 40 were diagnosed as spinal tumour by MRI and among them 39 were confirmed by histopathological evaluation. They were true positive. One case was diagnosed as having spinal tumour by MRI but not confirmed by histopathological findings. That was false positive. Out of 11 cases of non tumour which were confirmed by MRI, 3 were confirmed as spinal tumour and 8 were non-tumour by histopathological findings. They were false negative and true negative respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MRI in the diagnosis of spinal tumour were 92.86%, 88.89%, 97.50%, 72.73% and 92.15% respectively.Conclusion: The present study conducted to assess the diagnostic usefulness of MRI in evaluation of spinal tumors among the Bangladeshi population. Study revealed high sensitivity, specificity and accuracy of the MRI in the diagnosis of spinal tumour. MRI should be the initial procedure in the evaluation of suspected tumors of the spine.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 162-166