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  • A journey through the spinal cord lesions : an institutional experience

    Final Number:

    Natarajan Meenakshisundaram Mch; Thiruvalluvan A; Raghavendhar R

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting - Late Breaking Science

    Introduction: The most common spinal cord lesions is Primary spinal cord tumors which are uncommon neoplasms that account for 2% to 4% of central nervous system tumors. Spinal tumors have histori¬cally been classified according to their location in relation to the dural sac as extradural, intradural intramedullary and intradural extramedullary. Most primary spinal tumors are benign.

    Methods: A descriptive study of patients admitted with spinal cord lesions in the Institute of Neurosurgery, Madras Medical College was done from 01/01/2016 to 31/12/2016. 52 patients were admitted and operated during this study period. These 52 patients were analysed and studied based on several parameters like age and sex distribution, tumour classification and distribution, tumour location, imaging and histopathology discrepancies, squash and histopathology discrepancies and Immunohistochemistry.

    Results: Total patients studied were 52. Most common age group affected was between 41 to 60 years - 23 patients(44%) and predominantly affecting male population - 28 patients(53%). Most common tumour classification is Intradural extramedullary - 36 patients(69%) and common location is in thoracic region for 19 patients(36%). There were 2 patients(3%)with intradural and extradural extension. There was discrepancy between the imaging and histopathology report for 15 patients(29%). For 6 patients(11%) there was discrepancy between squash and histopathology. In about 24 patients(46%) lesions most commonly involve 2 segments. In about 10 patients(19%) they involve more than 5 segments. The most common tumour histology reported is schwannoma for 16 patients(30%) followed by meningioma for 13 patients(25%). The most common tumour reported in paediatric age group is round cell tumour and that in adult is schwannoma. Functional outcome was better with extradural and intradural extramedullary tumours .

    Conclusions: Spinal cord lesions is a major cause of morbidity than mortality amongst the CNS lesions. Hence the knowledge about the concepts of spinal cord lesions is essential.

    Patient Care: There are less datas available to study the spinal cord lesions. Hence this institutional study will enlighten the concepts in the diagnosis, management of spinal cord tumours and functional outcome post operatively.

    Learning Objectives: By the conclusion of this session, participants should be able to elucidate the incidence of spinal cord lesions, age and sex distribution, tumour classification and distribution, tumour location, imaging and histopathology discrepancies, squash and histopathology discrepancies, Immunohistochemistry and functional outcome postoperatively.

    References: 1.SPINAL CORD TUMOURS. Alex. Mills Kennedy, M.D. GLASG., M.R.C.P. LOND.Lambert Rogers 2.Epidural spinal cord compression from metastatic tumor: Diagnosis and treatment Robert W. Gilbert MD,Jae-Ho Kim MD,Dr Jerome B. Posner MD 3.Radical excision of intramedullary spinal cord tumors: surgical morbidity and long-term follow-up evaluation in 164 children and young adults Shlomi Constantini, M.D., M.Sc., Douglas C. Miller, M.D., Jeffrey C. Allen, M.D., Lucy B. Rorke, M.D., Diana Freed, and Fred J. Epstein, M.D. 4.Radical resection of intramedullary spinal cord tumors in adults Recent experience in 29 patients Paul R. Cooper, M.D., and Fred Epstein, M.D. Department of Neurosurgery, New York University Medical Center, New York, New York 5.Acta Neurochirurgica June 1992, Volume 116, Issue 2–4, pp 176–178 Surgery of intramedullary spinal cord tumours Authors and affiliations J. BrotchiJ. NotermanD. Baleriaux

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