1607. Intradural Spinal Tumors: Surgical considerations and Institutional Experience

Authors: Domagoj Gajski, MD; Ante Rotim, MD; Tomislav Sajko; Kresimir Rotim (Zagreb, Croatia)

Introduction:

In UHC Sisters of Mercy in Zagreb, Croatia, we have done research of outcome after intradural spinal tumor surgical removal. Also in the presentation we have prepared 4 cases with 3 intraoperative video to show the technique of procedure.

Methods:

We have done retrospective analysis of the patients with intraduralspinal tumors operated in UHC Sisters of Mercy from 2010 to 2017. We have done preoperative evaluation of the:
1. PAIN 
- Visual Analogue Scale (VAS) 1 - 10
2. NEUROLOGIC DEFICIT 
-no deficit (N)
-sensory (S)
-motoric (M)
-sensomotor(SM)
-sphincter deficit (SMD)

 

Results:

We have showed that the location where this tumors mostly occur is:

  1. for Schwanomas and ependimomas lumbar spine
  2. for meningiomas toracal spine etc.

The best postop resolution of pain was after surgery of ependimomas VAS 0, Schwanomas VAS 1, and the worst was for neurofibromas; only 1 less than before surgery. Pain and location of the tumor showed us the worst resolution in toracal spine. We aslo had full recovery in all cases with sphincter deficit, 50% recovery in sensory deficit, and the worst results with motor deficit - there was no recovery at all. We have done follow up 4 to 36 months. We measured hospital stay, mean was 9 days, 3 complications, 2 liquorrheas and 1 pneumonia. There was no need for fusion after surgeries.

Conclusion:
Postoperative reduction of pain and neurological deficit in all patients.
Histological type of the tumor has no impact on pre and postoperative neurological status and pain.
Advanced age is not a contraindication for surgery.
LOCATION EFFECTS THE POSTOPERATIVE NEUROLOGICAL DEFICIT,  showing worse results for cervical and thoracal tumors.