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Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience.

Publication ,  Journal Article
Mehta, AI; Adogwa, O; Karikari, IO; Thompson, P; Verla, T; Null, UT; Friedman, AH; Cheng, JS; Bagley, CA; Isaacs, RE
Published in: J Neurosurg Spine
December 2013

OBJECT: Intradural extramedullary (IDEM) neoplasms are uncommon lesions that can pose a challenge for resection. Numerous factors affect the resectability and ultimately the outcome of these lesions. The authors report their 10-year institutional experience with the resection of IDEM neoplasms, focusing on the effect of location on surgical outcomes. METHODS: The authors performed a retrospective review of 96 consecutive patients who presented with a cervical and/or thoracic IDEM tumor that was resected between February 2000 and July 2009. All patients underwent MRI, and the axial location of the tumor was categorized as anterior, posterior, or lateral. Postoperative complications were assessed, as was neurological status at the patient's last follow-up clinic visit. Major complications assessed included CSF leakage requiring lumbar drainage, reexploration for epidural hematoma, and major postoperative neurological deficits. RESULTS: The mean ± SD age at presentation was 51.16 ± 17.87 years. Major surgical approach-related complications occurred in 15% of patients. Major non-approach related surgical complications occurred in 7.1% of patients, while minor complications occurred in 14.2% of patients. Postoperative neurological deficits occurred most commonly in the thoracic spine between T-1 and T-8. Based on axial spinal cord location, the surgery-related complications rates for all anterior tumors (n = 12) was 41.6%, whereas that for all lateral tumors (n = 69) was 4.4% and that for all posteriorly located tumors (n = 17) was 0%. CONCLUSIONS: Spinal IDEM tumors that are anteriorly located in the upper thoracic spine were found to have the highest rate of surgery-related complications and postoperative neurological deficits. This finding may be associated with the unforgiving anatomy of the upper thoracic spine in which there is a higher cord-to-canal ratio and a tenuous vascular supply.

Duke Scholars

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

December 2013

Volume

19

Issue

6

Start / End Page

701 / 707

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Thoracic Vertebrae
  • Spinal Cord Neoplasms
  • Retrospective Studies
  • Postoperative Complications
  • Orthopedics
  • Neurosurgical Procedures
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mehta, A. I., Adogwa, O., Karikari, I. O., Thompson, P., Verla, T., Null, U. T., … Isaacs, R. E. (2013). Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience. J Neurosurg Spine, 19(6), 701–707. https://doi.org/10.3171/2013.9.SPINE12913
Mehta, Ankit I., Owoicho Adogwa, Isaac O. Karikari, Paul Thompson, Terence Verla, Ulysses T. Null, Allan H. Friedman, Joseph S. Cheng, Carlos A. Bagley, and Robert E. Isaacs. “Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience.J Neurosurg Spine 19, no. 6 (December 2013): 701–7. https://doi.org/10.3171/2013.9.SPINE12913.
Mehta AI, Adogwa O, Karikari IO, Thompson P, Verla T, Null UT, et al. Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience. J Neurosurg Spine. 2013 Dec;19(6):701–7.
Mehta, Ankit I., et al. “Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience.J Neurosurg Spine, vol. 19, no. 6, Dec. 2013, pp. 701–07. Pubmed, doi:10.3171/2013.9.SPINE12913.
Mehta AI, Adogwa O, Karikari IO, Thompson P, Verla T, Null UT, Friedman AH, Cheng JS, Bagley CA, Isaacs RE. Anatomical location dictating major surgical complications for intradural extramedullary spinal tumors: a 10-year single-institutional experience. J Neurosurg Spine. 2013 Dec;19(6):701–707.

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

December 2013

Volume

19

Issue

6

Start / End Page

701 / 707

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Thoracic Vertebrae
  • Spinal Cord Neoplasms
  • Retrospective Studies
  • Postoperative Complications
  • Orthopedics
  • Neurosurgical Procedures
  • Middle Aged
  • Male