Samra Majeed, Fareeha Majid, Nayyara Tahir, Waqar Azim, Azam Niaz, Azam Niaz, Anjum Habib Vohra.
Multidisciplinary Management and Outcome of Intradural Extramedullary Spinal Tumors.
Pak J Neuro Surg Jan ;26(2):270-6.

Introduction/Objective: About fifteen percent of the primary CNS tumors are intraspinal. About two-thirds of tumors are intradural extramedullary (IDEM). This study was conducted to review the outcome of operative management of intradural extramedullary tumors in correlation with the factors, both clinical & histopathological, influencing the neurology of patients & prognosis. Materials and Methods: It was a multicenter study including 42 patients conducted from December 2018 to December 2020. All patients were diagnosed by MRI with and without contrast. Patients were surgically treated & analyzed for clinical features i.e., pain by visual analog scale (VAS) & neurology by modified McCormick scale both preoperatively & post-operatively. Clinical features & outcomes were correlated with tumor size & histopathology. p-value < 0.05 was considered significant. Results: This study included 42 cases. The most common diagnosis was schwannoma (76.19%). The average intradural space occupied at presentation was 82%. The most common location was dorsal (90.4%). The visual analog score for pain (VAS) improved in all patients post-operatively from 7 +- 1.9 to 2 +- 0.8 (p = 0.003) & modified McCormick scale from 3.0 +- 1.3 to 2.0 +- 1.0 (p = 0.005). The preoperative symptoms were correlated with the only size of the tumor occupying the intradural space (VAS p = 0.021, modified McCormick scale p = 0.018). Conclusion: All the tumors excised showed some improvement in neurological status. Therefore, all patients diagnosed with IDEM should be operated on even if present with prolonged symptoms or severe neurological compromise.

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