Microsurgery for Intradural Spinal Tumors

Abstract

About half of all spinal tumors are intradural. Due to their location and close proximity with the delicate neural structures, surgical removal requires great expertise and delicacy. Intramedullary tumors can hardly be removed without the help of the operating microscope and other microsurgical techniques. During a period of 18 months, 12 intradural tumors were operated upon in the Department of Neurosurgery, Aziz Fatimah Trust Hospital, Faisalabad. Out of the seven-extra medullary tumors, 4 were neurofibromas, 2 were arachnoid cysts and one was a meningioma. The five intramedullary lesions depicted a great histological variety; one ependymoma, one neurenteric cyst, one dermoid, one lipoma and one was reported as fibrous tissue. All neurofibromas were removed totally, while both arachnoid cysts were decapitated. Removal was total in three of the intramedullary lesions and sub-total in two. Ten patients (83.3%) improved after surgery. One patient (8.3%) remained at the same neurological status while one patient (8.3%) with a very large intramedullary ependymoma had a mild deterioration in motor power. We conclude that complete removal of most intradural tumors is possible without increasing the neurological deficit.