Spinal cord tumour presenting as neck pain

Abstract

In April 2003, a 48-year-old GP was admitted to the authors' hospital with severe neck pain. He had a 2-week history of progressively worsening neck pain without antecedent trauma or strain. Pain was initially relieved by paracetamol, but progressed to waking him from sleep and became continuous during the day. Physiotherapy and opiates did not alleviate symptoms. Power, sensation and sphincter functions were unaffected. After a further week of unremitting pain, neurosurgical referral was made. A magnetic resonance imaging scan showed an intrinsic spinal cord tumour extending from C3 to C6 level (Figure 1). Urgent laminectomy and resection of tumour was performed. Complete excision was possible as the tumour had not infiltrated into surrounding normal cord. Pathology confirmed intramedullary ependymoma. After a short period in a spinal rehabilitation unit followed by regular outpatient physiotherapy the patient regained full function, resuming work, and was even able to participate in a local relay marathon 2 years later.