الفهرس | Only 14 pages are availabe for public view |
Abstract Intradural spinal tumours (IDSTs) are uncommon and are classified as intramedullary or extramedullary based on their location within the spinal cord. The most common intramedullary neoplasms are ependymomas and astrocytomas, whereas the commonest intradural-extramedullary neoplasms are meningiomas and shwanomas. Magnetic resonance imaging (MRI) is the most sensitive and reliable diagnostic tool to be used for early diagnosis of such lesions. Surgery is the primary treatment modality for these tumours, aiming for gross total resection with preservation of neurological function. Surgery alone may control the disease progression, but adjuvant therapy may be used as an add-on therapy in cases of subtotal resection and high grade tumors. Our study discussed the prognostic factors and functional outcome after surgical management of 30 patients with spinal intradural tumours operated between March 2020 and March 2021 in Alexandria Armed Forces Hospital and Menoufia University Hospital. The clinical presentation was obtained prior to surgery. The postoperative outcome was classified using the Modified McCormick Scales (MMS) immediately postoperative, 6 months, and 1 year. The study included 13 males and 17 females, with ages ranging from 21 to 60 years. Patients with metastatic lesions and tumor-like conditions were excluded. We have 16 patients with extramedullary tumours and 14 patients with intramedullary tumours. Meningioma was the most common extramedullary tumour in 9 patients, followed by schwanoma in 4 patients, Summary 106 while ependymoma was the most common intramedullary tumour in 9 patients, followed by astrocytoma in 5 patients. The mean duration of symptoms was 9 months. All our cases (30 cases) had pain as a presenting symptom, followed by sensory manifestation in 24 cases, then motor weakness in 23 cases, and 7 cases with autonomic dysfunction. GTR was achieved in 21 patients (70%). Intraoperative monitoring was used in 10 cases (33.3%), and ultrasonic aspiration was used in 20 cases (66.7%). Besides, 11 cases (36.6%) underwent postoperative adjuvant therapy. The mean preoperative MMS was (2.70±0.88) and improved to (1.93 ± 1.51) at 1 year follow up. As regards the postoperative complications, there were 5 cases (16.7%) with postoperative deterioration of neurological status; 4 cases (13.3%) developed CSF leaks; 3 cases (10%) showed tumour recurrence; and 1 case had postoperative wound infection. |