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Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome
Sharadendu Narayan1, Shrikant V Rege2, Rakesh Gupta3,4
1Neurosurgery, Tata Main Hospital, Jamshedpur, IND.
Cureus
|July 21, 2021
Summary
Intradural extramedullary (IDEM) spinal tumors are typically benign and surgically treatable. Surgical excision offers good functional outcomes for most patients, though larger tumors and longer symptom duration may predict less optimal results.
Area of Science:
- Neurosurgery
- Spinal Oncology
- Neurology
Background:
- Intradural extramedullary (IDEM) spinal tumors constitute a significant portion of intraspinal neoplasms, often presenting as benign conditions.
- These tumors are generally amenable to complete surgical removal, with a high potential for favorable patient outcomes.
Purpose of the Study:
- To evaluate the surgical outcomes and functional recovery in patients with intradural extramedullary spinal tumors.
- To identify factors influencing surgical success and potential complications in the management of IDEM tumors.
Main Methods:
- Retrospective review of 35 patients undergoing surgical excision of IDEM spinal tumors.
- Data collected included patient demographics, symptom severity and duration, tumor characteristics, and preoperative/postoperative neurological status.
- Neurological function was assessed using Frankel and Nurick grading systems; pain was evaluated with the Denis Pain Scale (DPS).
Main Results:
- Common histopathological diagnoses included schwannoma (12), meningioma (9), and neurofibroma (6).
- Prevalent symptoms were paresthesia/numbness (88.6%) and limb weakness (80%).
- 77.14% of patients achieved good functional outcomes (improved Frankel score), with significant improvements in neurological scores and pain scales post-surgery (p<0.0001).
Conclusions:
- IDEM tumors are predominantly benign, well-visualized with contrast-enhanced MRI, and typically yield excellent surgical results.
- Factors such as greater spinal canal occupancy and prolonged symptom duration correlate with less favorable functional outcomes.
- Surgical intervention leads to significant functional improvement, underscoring its efficacy in managing these spinal neoplasms.
