Surgical Experiences with Intradural Spinal Metastases from Systemic Neoplasms

Abstract

Intradural metastasis of neoplasms from non-CNS origin is rare. In the English literature, there is no report regarding intradural spinal metastasis from such tumors concerning oriental population. We present a retrospective review of 12 spinal intradural metastases. Clinical history, symptom/signs, surgical approach and surgical outcome were obtained by review of patient charts. All of the patients had presented some degree of limb weakness in addition to other symptoms. The most common primary tumor was carcinoma of the lung. The most common site of metastasis was the thoracolumbar junction. All patients underwent laminectomy with total or partial tumor removal. Of the 12 patients, 6 patients reported muscle power improvement, 4 remained the same, and 2 deteriorated. Our results indicated that, for patients with intradural extramedullary metastatic lesion, laminectomy with tumor removal under SSEP monitoring provided pain relief, muscle power/functional status restoration and pathology proof. For intramedullary lesion, the result of surgical treatment is less satisfactory. Nonsurgical treatment may be warranted, particularly for radiosensitive tumors.