Outcomes of the surgical resection of intradural extramedullary tumors

Abstract

Aim To evaluate the postoperative status after the tumor resection and compare it with the preoperative status. Background The intradural extramedullary tumors remain curable diseases and carry a favorable outcome. Early diagnosis is crucial to improve the outcome. Resection of the intradural extramedullary tumors improves the pain and the functional outcome of the patients. Patients and methods A retrospective study was done in the Neurosurgery Department, Sohag Faculty of Medicine, to patients diagnosed with intradural extramedullary tumors confirmed by MRI spine between April 2014 and April 2018. Forty-two cases were presented with female predominance, with mean age 46.6 ± 17 years with different presentations. They were operated and follow-up was done for 1 year postoperatively. They were evaluated preoperatively regarding pain, motor, and sphincteric function. Results The most frequent symptom was back and leg pain (88.1%), followed by paraparesis (23.8%), sensory disturbances in seven (16.7%) patients, and urinary incontinence in seven (16.7%) patients. The most common pathology was schwannoma (61.9%). Surgical resection improves the outcome in 35 (83.3%) patients. The dorsal spine was mostly affected in 30 patients followed by the lumbar spine in nine patients. The most effective prognostic factor was the early surgical intervention. Complications were reported in 19 patients, including cerebrospinal fluid leak, urinary incontinence, and wound infection. Conclusion These types of tumors have excellent results after excision. We recommend early intervention, irrespective of the tumor location or the pathology. After total excision, marked improvement regarding pain and neurological function was reported, while the recurrence rate was less than 2.5%. Prognostic factors include tumor extension, time of intervention, and Simpson grade of excision.