J Korean Soc Spine Surg.  2011 Jun;18(2):43-50.

Clinical Characteristics and Surgical Results of Spinal Intradural Tumor

• Kim WJ
• Koo JY
• Bae KW
• Kang JW
• Park KY
• Kang SI
• Choy WS

Abstract

STUDY DESIGN: A retrospective study about spinal intradural tumor.
OBJECTIVES
We analyzed clinical symptom, findings of MRI, and surgical outcome of spinal intradural tumor. SUMMARY OF LITERATURE REVIEW: Intradural tumors are not commonly reported and they show non-specific clinical features.
MATERIALS AND METHODS
In this study, 18 patients who underwent surgical treatment and radiologically and pathologically diagnosed as spinal intradural tumor from 1997 to 2009 were reviewed. We evaluated pain, neurological symptoms, location of tumor as well as degrees of signal intensity and its enhancement of MRI(T1 and T2). And clinical outcomes were analyzed according to Klekamp-Samii scoring system and Visual Analogue Scale(VAS).
RESULTS
All patients were clinically suffered from back pain and radiating pain of lower extremity including 3 patients with neurological symptoms. We radiologically found single tumor in 16 cases and masses more than two lesion in 2 cases. 1 case was located on cord level(T7), 14 cases cauda equine level, and 3 cases sacral level. We performed laminectomy in 18 cases and posterior instrumentation was applied to 8 cases. In clinical features, mean Klekamp-Samii score was improved from 21.6 to 23.5(p<0.05) and VAS was recovered from 5.2 to 3.0 (p<0.05).
CONCLUSIONS
Spinal intradural tumor has non-specific clinical symptoms. Therefore we should perform MRI to find intradural tumor and active management including surgical treatment should be performed due to clinically good results.

Keyword

Spinal intradural tumor; MRI; Clinical symptom

MeSH Terms

Back Pain
Humans
Laminectomy
Lower Extremity
Retrospective Studies

Figure

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  Fig. 1. Anteroposterior(A) and lateral(B) radiographs show non-specific findings.

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  Fig. 2. There are well-defined masses lesion with intermediate signal intensity on both T1(A) and T2 weighted images(B) at the level of L1 and L4, re-spectively. The lesions show homogenous, strong enhancement(C).

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  Fig. 3. Intraoperative photograph shows totally encapsulated intradural mass(A). Two encapsulated tumors are resected from different locations(B, C).

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  Fig. 4. Histopathologic findings show excised mass consists of Antony A and Antony B type portions.

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  Fig. 5. Enhanced MRI show schwannoma with peripheral enhancement on sagittal (A) and axial(B) images.

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