Background: Spinal cord neoplasms constitute one of the major aspects of neurosurgical practice. Of the different types based on location, intradural extramedullary neoplasms are the commonest. Most are benign, including nerve sheath tumours and meningiomas.
Methods: A series of 41 cases of intradural extramedullary spinal tumours located at different levels, surgically excised at our centre over a period of 2 years from 2018 are evaluated. Demographic distribution, clinical presentations, radiological aspects, pathological classifications and postoperative clinical status of the patients are being analysed along with the correlation of functional outcome with histopathology.
Results: Age and sex distribution of IDEM tumours were such that there was an almost equal number of males and females, while most belonged to the group of 20-50 years. Lesions were common at the dorsal level followed by the lumbar region. Cervicothoracic junction tumours were rare. Benign nerve sheath tumours viz. schwannoma and neurofibroma were the commonest types followed by meningioma and myxopapillary ependymoma. The mean symptom duration till radiological diagnosis is 8 months. Commonly seen symptoms are backache, limb weakness and radicular pain. Sphincter disturbances were less common.
According to modified Frankel grading, the majority of the patients belonged to grades D and E both preoperatively and after surgery. On a visual analogue scale for pain, mean values dramatically decreased over a period of 1 year after surgery.
Complications were relatively rare. Mild worsening of neurological functional status was noted in 5 patients. No instances of surgical site infection were noted.
Neurological worsening was seen only in cases of anteriorly located meningiomas and malignant peripheral nerve sheath tumours.
Key words: Intradural extramedullary spinal neoplasm, Laminectomy, Neurofibroma, meningioma
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