OUTCOME OF INTRAMEDULLARY SPINAL CORD TUMOURS: EXPERIENCE WITH 18 PATIENTS OPERATED AT AYUB TEACHING HOSPITAL, ABBOTTABAD
AbstractBackground: Intramedullary spinal cord tumours (IMSCT) are among the uncommon lesions at spinalcord. They can present with a vast array of symptoms and cause severe neurological deficits. Withadvent and frequent use of MRI more and more patients with IMSCT are picked up. By using modernmicrosurgical techniques better surgical outcome is achieved. The Objective was to analyse the surgicaloutcome of the patients with intramedullary Spinal Tumour operated at Ayub Teaching Hospital(ATH), Abbottabad. Methods: Eighteen patients with IMSCT who presented at Neurosurgery Unit,ATH, Abbottabad during 2000–2010 were included in this study. Patients were diagnosed on the basisof MRI. They were operated using standard microsurgical techniques. Patients were followed up for amean duration of 18 months after surgery and their preoperative and postoperative neurological statuswas analysed. Results: Patients with age group ranging from 15–50 (37.72±8.94) years with IMSCTwere operated. Sixty-one percent of the patients were male and 39% were female. The region mostcommonly affected was cervical (44%) followed by conus medullaris (33%), cervicothoracic andthoracic each had frequency of 11%. Gross total removal (>95%) was possible in 72% of cases while inrest of 28% cases resection of 80–95% was possible. Histologically 38.9% of the lesions wereependymomas, 27.8% were astrocytomas and 22.2% were teratomas. Neurofibromas and PrimitiveNeuroectodermal Tumours (PNET) each accounted for 5.5% of the cases. Overall postoperativeneurology improved in 10 (55%) of patients, remained unchanged in 5 (27%) of cases, and deterioratedin 3 (16%) patients. One patient was lost in follow-up. Surgery on tumours in cervical and thoracicregion carried a relatively poor outcome as compared to the lesion of conus. There were no deaths dueto surgery. Conclusion: Surgical removal of IMSCT is beneficial to patients with acceptable surgicalrisk. Better outcome is expected if the patients with good Frankel grade are diagnosed and operatedearly the course of disease.Keywords: Spinal tumours, Intramedullary spinal tumour, Ependymoma
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