الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Intradural spinal tumours (IDSTs) are uncommon and are classified as
intramedullary or extramedullary based on their location within the spinal
cord. The most common intramedullary neoplasms are ependymomas and
astrocytomas, whereas the commonest intradural-extramedullary neoplasms
are meningiomas and shwanomas.
Magnetic resonance imaging (MRI) is the most sensitive and reliable
diagnostic tool to be used for early diagnosis of such lesions. Surgery is the
primary treatment modality for these tumours, aiming for gross total resection
with preservation of neurological function. Surgery alone may control the
disease progression, but adjuvant therapy may be used as an add-on therapy in
cases of subtotal resection and high grade tumors.
Our study discussed the prognostic factors and functional outcome after
surgical management of 30 patients with spinal intradural tumours operated
between March 2020 and March 2021 in Alexandria Armed Forces Hospital
and Menoufia University Hospital.
The clinical presentation was obtained prior to surgery. The
postoperative outcome was classified using the Modified McCormick Scales
(MMS) immediately postoperative, 6 months, and 1 year.
The study included 13 males and 17 females, with ages ranging from 21
to 60 years. Patients with metastatic lesions and tumor-like conditions were
excluded. We have 16 patients with extramedullary tumours and 14 patients
with intramedullary tumours. Meningioma was the most common
extramedullary tumour in 9 patients, followed by schwanoma in 4 patients,
Summary
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while ependymoma was the most common intramedullary tumour in 9
patients, followed by astrocytoma in 5 patients.
The mean duration of symptoms was 9 months. All our cases (30 cases)
had pain as a presenting symptom, followed by sensory manifestation in 24
cases, then motor weakness in 23 cases, and 7 cases with autonomic
dysfunction. GTR was achieved in 21 patients (70%). Intraoperative
monitoring was used in 10 cases (33.3%), and ultrasonic aspiration was used
in 20 cases (66.7%). Besides, 11 cases (36.6%) underwent postoperative
adjuvant therapy. The mean preoperative MMS was (2.70±0.88) and
improved to (1.93 ± 1.51) at 1 year follow up.
As regards the postoperative complications, there were 5 cases (16.7%)
with postoperative deterioration of neurological status; 4 cases (13.3%)
developed CSF leaks; 3 cases (10%) showed tumour recurrence; and 1 case
had postoperative wound infection.