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  • Spinal intramedullary tumors: an analysis based on 52 cases

    Final Number:

    Awadhesh K. Jaiswal MBBS MCh; Sushila Jaiswal MD; Rabi Sahu; Sanjay Behari MCh DNB

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Spinal intramedullary tumors comprise 4% of central nervous system tumors and 20% of all intraspinal tumors. This study was performed to evaluate the clinical features, histological spectrum, microsurgical techniques and outcome of spinal intramedullary tumors.

    Methods: The study was performed by retrospective review of the medical records of the patients of spinal intramedullary tumors operated in our department.

    Results: 52 patients (41 males and 11 females; age ranged from 18-57 years) with spinal intramedullary tumors were surgically treated at our institution over last 7 years. The mean duration from onset of symptoms to surgery was 12.6 months. Most common symptom was motor dysfunction (90.8%) followed by sensory dysfunction (90%) and sphinteric dysfunction (59%). Most common location of tumor was cervical (23 cases) followed by thoracic (10 cases), cervico-thoracic and conus (6 cases) each, dorso-lumber (5 cases) and lumber (2 case). Total surgical excision was achieved in 31 cases, subtotal excision in 19 cases and biopsy was done in 2 cases. Most common histology was ependymoma (32 cases), followed by astrocytoma (11 cases), hemangioblastoma (6 cases), neurenteric cyst (2 cases) and cavernoma (1 case). Following surgery, 22 patients improved, 17 patients had transient worsening which recovered in follow up, 10 patients were neurologically stabilized and 3 patients worsened. There was no mortality in our series.

    Conclusions: Spinal intramedullary tumors presents with a wide variety of neurological dysfunction. Ependymoma is the most common spinal intramedullary tumors. With modern neurosurgical advances, surgery offers favourable outcome in most of the cases.

    Patient Care: This presentation will provide details of surgical details of spinal intramedullary tumor to minimize the complications resulting a better outcome.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1)Know the presentation and management of spinal intramedullay tumor, 2)Know the details of the technique of microsurgical excision of spinal intramedullay tumor

    References: Samii M, Kleklamp J: Surgical results of 100 intramedullary tumors in relation to accompanying syringomyelia. Neurosurgery 1994; 35: 865-873.   Minehan KJ, Shaw EG, Scheithauer BW et al: Spinal cord astrocytoma: pathological and treatment considerations. J Neurosurg 1995; 83: 590-595.       Epstein FJ, Farmer JP, Freed D: Adult intramedullary astrocytomas of the spinal cord. J Neurosurg 1992; 77: 355-359.       Cristante L, Hermann HD: Surgical management of intramedullary spinal cord tumors. Functional outcome and sources of morbidity. Neurosurgery 1994; 35 : 69-76.

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