[Clinical analysis of 22 spinal neurinomas--with special reference to ct metrizamide myelography and CO2 laser--]

Twenty-two spinal neurinomas, admitted to the Department of Neurosurgery, Kyoto University Medical School during the past 40 years, were retrospectively analysed under the circumstances that most of lower spinal and or spinal cord tumors had usually been handled by orthopedic surgeons in Japan. Of the total of 22 cases, there were 14 cervical, 6 thoracic and 2 lumbar neurinomas. Age distribution was from 16 to 70 years of age with the average 38. Von Recklinghausen's disease accompanied spinal neurinoma in 4 cases. Of 3 cases under the age of 20, two were associated with von Recklinghausen's disease. Motor deficits were the prominent clinical symptoms on admission in 63% of the cases, while pains were the initial symptoms in 77% of the cases. Twenty-nine percent of cervical neurinomas were of dumbbell type, extending both in the intraspinal and extraspinal spaces. In addition to the conventional neuroradiologic investigations, CT metrizamide myelography was extremely advantageous in detecting the localization and relation of spinal neurinomas to the spine and spinal cord as well as bony changes. Laser surgery was utilized in the recent two cases of spinal neurinomas of dumbbell type. It was found useful in that it enabled intraspinal decompression by a non-touch technique prior to laminectomy.