Microsurgical treatment for spinal tumours

Although spinal tumours are amenable to total surgical excision, the factors determining the outcome are diverse. This study re-evaluates aspects of the disease that contribute to their outcome.

Ninety-three consecutive patients with spinal cord tumours that underwent microsurgical excision between February 1992 and February 2002 were retrospectively studied. All patients underwent magnetic resonance imaging and had histological confirmation of spinal tumours.

There were 44 men and 49 women with a mean age of 49.05 years (range 6 to 83 years). The location of the tumours was cervical in 37 cases, thoracic in 41 cases, lumbosacral in 13 cases, and multilevel in two cases. The mean tumour size was 2.2 cm (range 0.8 to 7 cm) and mean duration of symptoms was 10.8 months. Complete excision was achieved in 72 cases and incomplete removal in 15 cases. The mean follow-up period was 21.45 months (range 3 days to 8 years). Immediate post-operative improvement was noted in 40 (43 percent) patients, 24 (25.4 percent) improved within six months, 13 (14 percent) improved after six months, 12 (12.9 percent) had no improvement and four patients died. The duration of symptoms and the completeness of excision were factors that correlated with post-operative improvement (p-value is less than 0.05). Age, gender, size, histological type, presenting symptoms, spinal level affected and axial location of tumour did not correlate with the outcome.

Microsurgical excision of spinal cord tumours is a safe and effective procedure, and post-operative outcome is correlated to duration of symptoms and the extent of tumour resection.