Extramedullary spinal tumors: Cross-sectional study of the demographic characteristics and treatment outcomes of surgically treated patients from Isfahan (Iran)

Abstract

Background: Extramedullary tumors account for a small percentage of all the tumors of the central nervous system and spine. Objectives: We aimed to determine the demographic characteristics and outcomes of treatment of patients with surgically resected extramedullary spinal tumors who visited medical centers in Isfahan, Iran. Materials and Methods: This descriptive study was conducted in Alzahra and Kashani medical centers in Isfahan, Iran, between 2013 and 2021. Patients with extramedullary spinal tumors who underwent surgery were included. Data collected included the pain score as measured on the visual analog scale (VAS) for pain severity, and the patients' neurological and functional status before and after treatment, as assessed on the McCormick scale. Results: We enrolled 94 patients in the study. The most common extramedullary spinal tumors were nerve sheath tumors in 32 (34.1%) patients, meningiomas in 27 (28.8%), and metastases in 22 (23.4%). The median follow-up was 3.60 ± 2.33 years. Pain was reported by 89 (94.7%) patients, which remained unresolved in 11 (13.5%) even after treatment; 18 (19.1%) patients died, among whom 8 (44.4%) had metastatic disease. As per the McCormick scale, 35 of 62 patients (46.1%) had a complete recovery following the various treatments including surgery, chemotherapy, and radiotherapy in the follow-up. Conclusion: There is an analogous distribution of extramedullary spinal tumors in Iranian patients compared to global data. In Iran, nerve sheath tumors and meningiomas are the most common extramedullary tumor types, and pain is the most common initial manifestation of these tumors. Surgical intervention in patients with extramedullary tumors usually leads to complete recovery based on the McCormick scale and reduction of pain symptoms as per the pain–VAS.