Intradural Extramedullary Spinal Cord Tumors: A Retrospective Study of Tumor Types, Locations, and Surgical Outcomes

Introduction: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two thirds of all intraspinal neoplasms. The purpose of this report was to determine shortand long-term outcomes of surgical patients with IESCT, and to examine clinical features that could be helpful in management of patients with these lesions. Methods: A retrospective review of 67 operative IESCT cases between 1974 and 2001 was performed. Outcomes were scored at one month and at mean follow-up of 8.5 months postoperatively. In addition, patient demographics, tumor types and locations were also collected. Statistical analysis was conducted utilizing Chi-square and Student's t-tests. Results: There were 31 men and 36 women (mean age 48 y/o, range 18-87 y/o). Men presented at a younger age than women (44 vs 53 y/o, P<0.02). Fifty-seven (85%) patients presented with severe radiculopathy and/or myelopathy. The remaining 10 (15%) had symptoms typical of disc herniation. Mean duration of symptoms prior to diagnosis was 11 months. Schwannomas (36 patients) had the longest mean duration of symptoms (14.9 months), followed by meningiomas (21 patients, 8.4 months), and ependymomas (10 patients, 2 months). Sixty-three (94%) of patients demonstrated significant improvement at one-month and 62 (92%) at 8.5-month mean follow-up as compared to the index exam. Only 13/67 (19.4%) patients had residual focal deficits on long term follow-up. Conclusions: Surgery for IESCT should be expected to produce significant and dramatic improvement in great majority of patients. Demographic, tumor-specific and anatomic considerations may be clinically useful when approaching IESCT.