Abstract
Introduction: To report the treatment results of 19 patients who underwent excision of intradural extramedullary (IDEM) spinal tumors.
 Materials & Methods: This is a retrospective study. Patients’ records were retrieved from the electronic database of Grande International Hospital. There were 19 IDEM spinal tumors excised over a period of 6 years between January 2013 and August 2019 by a single surgeon. There were 11 (57.9%) males and 8 (42.1%) females with an average age of 48.37±21.87 years (range, 5-79 years). The mean postoperative follow-up period was 12.87±14.88 months (range, 15 days - 60 months). The histopathological findings, locations of the tumors, and clinical results were analyzed. Neurological findings were evaluated using ASIA grading system and pain was evaluated using VAS score.
 Results: Histopathologically the tumors were: 8 meningioma (42.1%), 4 schwannoma (21.1%), 4 neurofibroma (21.1%), 1 dermoid cyst (5.3%), 1 lipoma (5.3%), and 1 myxopapillary ependymoma (5.3%). Tumor locations were: dorsal in 10 (52.6%), lumbar in 5 (26.3%), lumbosacral in 2 (10.5%), dorsolumbar in 1 (5.3%), and cervical in 1 (5.3%) patient. Neurologic status of 7 patients was normal and 12 had neurologic involvement with 3 patients having Cauda Equina Syndrome (CES) preoperatively. At the final follow-up, 3-grade, 2-grade and 1-grade improvement in ASIA score was observed in 1, 6 and 1 cases, respectively. There was no change in the ASIA grade in 1 case. All 3 cases of CES achieved full neural recovery. Preoperative VAS score was 9.21±1.08 and improved significantly to 0.74±1.62 after surgery. Neurological improvement was seen in 91.67% with complete recovery in 75% of the cases and not a single case deteriorated neurologically post-surgery.
 Conclusion: Most intradural-extramedullary spinal cord tumors are mostly benign and good clinical results can be obtained when adequately treated with surgery.
Highlights
To report the treatment results of 19 patients who underwent excision of intradural extramedullary (IDEM) spinal tumors
Primary spinal cord tumors accounts for 2–4% of all primary central nervous system neoplasms which includes extradural, intradural-extramedullary (IDEM), and intramedullary tumors[1]
Diagnostic tools like CT and MRI, and the advancement of surgical instrumentation and techniques have improved the surgical outcome in IDEM tumors
Summary
To report the treatment results of 19 patients who underwent excision of intradural extramedullary (IDEM) spinal tumors. Primary spinal cord tumors accounts for 2–4% of all primary central nervous system neoplasms which includes extradural, intradural-extramedullary (IDEM), and intramedullary tumors[1]. No motor or sensory function preserved in the S4–5 segments account for 40-45% of all tumors found in the spinal canal2when complete, no further therapy is required. Incomplete tion preserved below the affected level and extending the myelon, and surgery is frequently through the S4–5 segments incomplete. Metastases, paragangliomas, sarcomas, spinal nerve sheath myxomas, and vascular tumors are other IDEM tumors[5]
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