Notes on a series of spinal cord tumors

Abstract

T HE diagnosis of the presence of a tumor within the vertebral cana is easy if the symptoms have been aIIowed to reach an advanced stage. But since the improvement foIIowing operative remova of the tumor varies inverseIy to the severity of the preoperative conditions, the earIier the tumor is extirpated, the better wiI1 be the resuIt. It is in the earIy diagnosis of spina cord Iesions that absorbing problems arise, for prompt remova of the tumor often resuIts in compIete cure. SpinaI cord tumors may be situated within the substance of the cord, without the cord but within the dura, or extradura1, between this sheath and the waIIs of the vertebra1 cana1. (See Figs. 1-3.) In whichever situation the tumor is pIaced, the symptoms have a common basis. Evidence appears of a Iesion of the spina cord and sIowIy and progressiveIy the symptoms increase in severity. Consideration of the situation in which spina cord tumors are found expIains the steady deveIopment of symptoms. The spina cord is an impuIse-conducting mechanism cIoseIy confined in the vertebra1 canal. At a certain point a neopIasm appears, which, as it grows, sIowIy compresses the cord against the bone, thus interfering more and more with its function. The probIem in reaching a diagnosis of spina cord tumor resoIves itseIf into three parts. Are the symptoms due to invoIvement of the spina cord? What segment of the cord is invoIved? Is the Iesion a degenerative process within the cord or is there a tumor present which shouId be removed surgicaIIy? The answer to the first question is usuaIIy easy, to the Iast two, it may be extremeiy difficuIt. LOCATION AND PATHOLOGY