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Extradural spinal tumors: report of 36 cases and review of literature
Author(s):
G. Sharma
Affiliations:
National Academy of Medical Sciences,Bir Hospital, Department of Neurosurgery, Kathmandu, Nepal; Nepal Mediciti, Department of Neurosciences, Kathmandu, Nepal
EANS Academy. Sharma G. Oct 21, 2018; 225678; EP2152
Prof. Gopal Sharma
Prof. Gopal Sharma
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Abstract
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About 55% of spinal tumors are extradural arising from vertebral bodies, epidural tissues and surrounding neural and soft tissues. More than 90% of extradural spinal tumors are metastatic lesions.
Extradural spinal tumors are common cause of back pain, sensory motor deficit and sphincters dysfunction.
The wide range of lesions and varied clinical profile, make management of spinal extradural tumors a challenging task for any neurosurgeon.
Aim of this study is to analyze and discuss the results of extradural spinal tumors after surgical intervention.

This is a retrospective study of 36 patients who were operated for spinal extradural tumors between May 2007 and December 2016 in our institute. Follow up period ranged from 18 months to 10 years. Functional outcome was assessed by McCormick' grading scale.

There were 20 male and 16 female and age ranged from 10 to 80 years. 30 patients presented with back pain and 15 had radicular pain. On presentation 18 patients had motor sensory deficit and 15 had sphincters dysfunction. Most common involved level was thoracic followed by cervical and lumbar. Gross total excision of masses was carried out in all cases. Common pathologies were neurofibroma (16), Ewing's sarcoma (7), granuloma (3), metastatic lesion (2), angiolipoma (2) etc. 12 patients who harbored malignant pathology received radio and chemotherapy. Postoperative wound infection occurred in 5 patients.
Regarding postoperative neurological status, 18 patients showed improvement, 6 patients remained same and 12 patients deteriorated. Recurrence occurred in 15 patients in 5 years' followed up. There was no surgery related mortality, however, 11 patients died during 3 years follow up due to natural course of malignant tumors.

Benign extradural spinal tumors have excellent result after total surgical excision, where as, malignant lesions, whether primary or secondary, have poor prognosis despite all modalities of treatment.
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