• Muhammad Junaid Combined Military Hospital, Peshawar
  • Afeera Asheen Combined Military Hospital, Peshawar
  • Muneeb Ur Rehman Army Medical College, National University of Sciences and Technology, Islamabad
  • Mamoon Ur Rashid Khyber Teaching Hospital, Peshawar
  • Syed Sarmad Bukhari Khyber Teaching Hospital, Peshawar
  • Mamoon Ahmed Army Medical College, National University of Sciences and Technology, Islamabad


Background: Tumours of the spinal cord, spinal meninges and cauda equina are relatively rare and their spectrum has not been studied extensively in Khyber Pakhtun Khawa province. We describe here the cases of spinal tumours treated in our setup over a period of two years. Methods: This Descriptive Case Series was carried out with of 80 patients operated in our centre from January 2013 to January 2015. The clinical presentation of these tumours as well as demographic findings was analysed. Patients who underwent surgery for their tumours were included in the study. Patients were selected for surgery depending on their radiological and clinical findings. Lesions that were suggestive of metastasis were biopsied and further care was shared between specialized departments depending on the primary source. Results: Male to female ratio was 1.5:1. Most of the spinal tumours were secondary tumours while meningiomas were the most common primary tumours. Most commonly patients belonged to young age group A (below 30 years.) 32.5%. Most common presentation was with paraparesis (27.5%) and paralysis (25%). A majority of patients regained good neurological function and did not show signs of recurrence at 1 year follow up. Conclusion: Given the limited experience at our centre, we believe that a wide range of spinal tumours can be successfully treated provided that clinical end points are kept in mind and treatment is individualized. Frankel grading is useful to assess surgical outcome in the patients.


Spinal tumor: MedlinePlus Medical Encyclopedia [Internet]. 2015 [cited 2015 Feb 21]. Available from: http://www.nlm.nih.gov/medlineplus/ency/article/001403.htm

Rosemberg S, Fujiwara D. Epidemiology of pediatric tumours of the nervous system according to the WHO 2000 classification: a report of 1,195 cases from a single institution. Childs Nerv Syst 2005;21(11):940–4.

Kumar V, Abbas AK, Aster JC, editors. Robbins and Cotran pathologic basis of disease. Ninth edition. Philadelphia, PA: Elsevier/Saunders; 2015. p.1391.

Goljan EF. Rapid review pathology. Philadelphia, PA: Saunders/Elsevier; 2014.

Schick U, Marquardt G, Lorenz R. Recurrence of benign spinal neoplasms. Neurosurg Rev 2001;24(1):20–5.

Schiffer D: Brain tumours. Pathology and its Biological Correlates. BRAIN Pathol-ZURICH-. 1993;3:193–3.

Helseth A, Mørk SJ: Primary intraspinal neoplasms in Norway, 1955 to 1986. A population-based survey of 467 patients. J Neurosurg 1989;71(6):842–5.

Setzer M, Vatter H, Marquardt G, Seifert V, Vrionis FD. Management of spinal meningiomas: surgical results and a review of the literature. Neurosurg Focus 2007;23(4):E14.

Sattar H. Fundamentals of pathology: medical course and step 1review. Chicago: Pathoma.com; 2011.

Hasselblatt M. Ependymal tumours. Recent Results Cancer Res 2009;171:51–66.

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007;114(2):97–109.

Paulino AC. Radiotherapeutic management of intracranial ependymoma. Pediatr Hematol Oncol 2002;19(5):295–308.

Engelhard HH, Villano JL, Porter KR, Stewart AK, Barua M, Braker FG, et al. Clinical presentation, histology, and treatment in 430 patients with primary tumours of the spinal cord, spinal meninges, or cauda equina. J Neurosurg Spine 2010;13(1):67–77.

Central Brain Tumor Registry of the United States. CBTRUS Statistical Report: Primary Brain tumours in the United States, 1998-2002. Hinsdale, IL: CBTRUS; 2005.

Schellinger KA, Propp JM, Villano JL, McCarthy BJ. Descriptive epidemiology of primary spinal cord tumours. J Neurooncol 2008;87(2):173–9.

Duong LM, McCarthy BJ, McLendon RE, Dolecek TA, Kruchko C, Douglas LL, et al. Descriptive Epidemiology of Malignant and Nonmalignant Primary Spinal Cord, Spinal Meninges, and Cauda Equina tumours , United States, 2004-2007. Cancer 2012;118(17):4220–7.

Gezen F, Kahraman S, Canakci Z, Bedük A. Review of 36 cases of spinal cord meningioma. Spine (Phila Pa 1976) 2000;25(6):727–31.

King AT, Sharr MM, Gullan RW, Bartlett JR. Spinal meningiomas: a 20-year review. Br J Neurosurg 1998;12(6):521–6.

Sandalcioglu IE, Gasser T, Asgari S, Lazorisak A, Engelhorn T, Egelhof T, et al. "Functional outcome after surgical treatment of intramedullary spinal cord tumours : experience with 78 patients."Spinal Cord 2005;43(1):34–41.

Choi GH, Oh JK, Kim TY, You NK, Lee HS, Yoon DH, et al. The clinical features and surgical outcomes of pediatric patients with primary spinal cord tumor. Childs Nerv Syst 2012;28(6):897–904.

Seppälä MT, Haltia MJ, Sankila RJ, Jääskeläinen JE, Heiskanen O. Long-term outcome after removal of spinal schwannoma: A clinicopathological study of 187 cases. J Neurosurg 1995;83(4):621–6.

Klekamp J, Samii M. Surgical results for spinal meningiomas. Surg Neurol 1999;52(6):552–62.

Segal D, Lidar Z, Corn A, Constantini S. Delay in diagnosis of primary intradural spinal cord tumours. Surg Neurol Int 2012;3(1):52.

Bhatti SN, Khan SA, Raja RA, Shah R, Aurangzeb A, Khan AA, et al. Outcome of intramedullary spinal cord tumours: experience with 18 patients operated at Ayub Teaching Hospital, Abbottabad. J Ayub Med Coll Abbottabad. 2010;22(3):15-7

Lantos PL, Vandenberg SR, Kleihues P, tumours of the nervous system. Graham DI, LantosPL: Greenfield's Neuropathology ed 6. London: Oxford University Press, 1997, p.583–879.

Gezen F, Kahraman S, Canakci Z, Bedük A. Review of 36 cases of spinal cord meningioma. Spine (Phila Pa 1976) 2000;25(6):727–31.

Gottfried ON, Gluf W, Quinones-Hinojosa A, Kan P, Schmidt MH. Spinal meningiomas: surgical management and outcome. Neurosurg Focus 2003;14(6):e2.

Peker S, Cerçi A, Ozgen S, Isik N, Kalelioglu M, Pamir MN. Spinal meningiomas: evaluation of 41 patients. J Neurosurg Sci 2005;49(1):7–11.

Slooff JL, Kernohan JW, MacCarty CS. Primary Intramedullary tumours of the Spinal Cord and Filum Terminale Philadelphia, WB Saunders, 1964.

Chen TC, Chamberlain MC. Adjuvant therapy for unresectable meningiomas: benign and malignant. Neurosurg Focus 2007;23(4):1.



Most read articles by the same author(s)