Functional outcomes in intradural extramedullary spinal tumors

Area of Science:

• Neurosurgery
• Spinal Oncology
• Neurology

Background:

• Intradural extramedullary (IDEM) spinal cord tumors constitute a significant portion of benign intraspinal neoplasms.
• Gross total excision is feasible, yet functional outcomes and quality of life vary.
• Understanding these outcomes is vital for effective treatment planning and patient care.

Purpose of the Study:

• To retrospectively analyze the surgical outcomes of patients with IDEM tumors.
• To evaluate the impact of tumor characteristics and location on functional recovery.
• To assess the effectiveness of surgical intervention in improving patient quality of life.

Main Methods:

• Retrospective review of 130 patients with IDEM tumors undergoing surgery (Jan 2017-Dec 2022).
• Analysis of patient demographics, symptoms, tumor characteristics (anatomical, pathological), and neurological status (Frankel grading).
• Assessment of back pain using the Denis Pain Scale (DPS).

Main Results:

• Common histopathologies included schwannoma (56), meningioma (37), and neurofibroma (16). Pain (38.5%) and limb weakness (31.5%) were primary symptoms.
• 93% achieved complete tumor resection; 49.3% showed significant functional improvement (Frankel score), with notable pain reduction (DPS).
• Ventral tumor location and poor preoperative neurological status correlated with poorer outcomes. Recurrence observed in 5.4%.

Conclusions:

• Surgical resection of IDEM spinal tumors generally leads to significant functional improvement and pain reduction.
• Ventral location, thoracic tumors, and poor preoperative neurological status are associated with less favorable outcomes.
• The morbidity associated with IDEM tumor resection is less substantial than previously considered.