Evaluation of Intradural Extramedullary Spinal Tumors Management: Single Institutional Experience

Abstract

Background: Surgical treatment of Symptomatic intradural extramedullary spinal (IDEM) tumors is the most effective treatment. The development in diagnostic and surgical techniques helped for early diagnosis and excellent surgical results. The aim of the present study is to overview the management experience of IDEM spinal tumor cases in our university hospital for upgrading our competency and sharing it with other institutions. Patients and methods: A retrospective study was conducted in which the medical records of patients who had surgical treatment for IDEM spinal tumors in between the periods from May 2015 to May 2020 in Benha University hospitals were evaluated and reviewed. Results: A total of 23 patients, 11 males and 12 females were included with a mean age of 41.04 (SD 10.32) years and mean follow up of 22.9 (SD 7.52) months. Nerve sheath tumor (neurofibromas and schwanomas) accounted for most of tumors (52.2%) followed by meningiomas (34.8%). The 6 cases managed using IONM had excellent outcome. hemilaminectomy was done in 4 (17.4%) patients, and fusion was needed in 4 (17.4%) patients. Patients' functional outcome was assessed using Frankel grades; we had postoperative 8E, 4D, and 1C grades compared to 7E, 8D, 5C, and 3B preoperatively, and 22 (95.7%) patients had improvement. VAS showed significant from 8.57 (SD 1.21) preoperatively to 1.33 (SD 1.39) at last follow up visit (P value <0.001). Conclusion: Surgical treatment of symptomatic an IDEM spine tumor is successful and safe with good functional outcome and pain improvement. Most tumors are benign. Use of IONM is helpful and small unilaterally located tumor can be approached via hemilaminectomy.