脊椎および脳神経外科ジャーナル

Features and Outcomes of Intra-Spinal Tumours: An Australian Neurosurgeons Experience

Darweesh Al-Khawaja, Tamadur Mahasneh, Mohamed Elmolla and Arun Kumar

Features and Outcomes of IntraSpinal Tumours: An Australian Neurosurgeon’s Experience

Intra spinal tumors are uncommon entity in Neurosurgical practice. Their diagnosis and treatment are often challenging and associated with significant morbidity and functional disability. We report a case series of intra spinal tumors encountered by a single neurosurgeon practicing at an Australian metropolitan Centre (population 400 000). Eighteen consecutive cases of metastatic tumors of the soft tissue epidural or intra dural component and benign spinal tumors treated surgically from 2008 to 2012 were reviewed retrospectively. Presenting symptoms, pain scores, initial and post-operative neurological and functional status, tumor histology, the use of adjuvant treatment and surgical approach were analyzed. A higher annual incidence of intra spinal tumors than previously reported for a single Centre (0.7 per 100,000) was evident from our study. Ependymoma, schwannoma and meningioma occurred in comparable ratio to the literature, in addition to two rare cases, one of Rosai-Dorfman disease and one of osteo chondroma. The incidence of non-osteolytic metastatic spinal tumors was slightly lower than that for primary tumors. Laminectomy and surgical decompression was sufficient to achieve total resection for the tumors in their primary origin. Two patients with metastatic spinal tumors required more radical intervention. The prevailing patterns of care and neurosurgical challenges in the treatment of spinal tumors are best determined by local epidemiological data in conjunction with wider population based analyses. This study illustrates the need for a national Australian registry for intra spinal tumors that will not only promote an awareness of this condition but also facilitate a more rapid diagnosis and aid in multidisciplinary management.