Intradural spinal tumors: 10 - years surgical experience in a single institution

The aim of the study is to present the therapeutic results of intradural tumor management over a 10 years period in a single institution.

The study consists in a prospective case series of patients treated at the neurosurgery service of the Social Security Institute of Mexico State and Provinces (ISSSEMYM), between January 2006 and December 2016. All patients were provided with information about the procedure and signed informed consent and institutional board approved files review for this study.

Thirty-five patients with intradural tumor were treated between 2006-2016. Most frequent lesions were extramedullary (30 patients, 85.7%). Most frequent tumor was Schwannoma, with thoracic/thoraco-lumbar location, being the most frequent location. All patients underwent surgical treatment, with total gross resection accomplished in 19 patients (54.3%). Surgical complication rate was 11.4%. Spine instrumentation was necessary in 26 patients (74.3%) because of bone destruction by the tumor, or bone removal for approach. All patients with intramedullary lesions and 5 patients (16.7%) with extramedullary lesions received post-operative radiotherapy. During the follow-up, 8.5% of patients had recurrence/progression of residual disease.

Microsurgery is the treatment of choice for intradural spinal tumors, and gross total resection with low morbidity must be the surgical goal. When this is not possible, partial resection and adjuvant therapy with radiosurgery are a valid option. Patients most be long followed-up because of recurrence risk or disease progression.