gms | German Medical Science

Introduction: Spinal surgery for benigne intraspinal intradural tumours is a frequent challenge for neurosurgerons. To evaluate factors influencing outcome, procedures performed for benigne spinal intradural tumour resection at the Klinik für Neurochirurgie, Nordstadtkrankenhaus Hannover between January 2003 and September 2007 were analyzed.

Material and methods: All patients operated on for benign spinal intradural tumours. Factors influencing the outcome such as tumour histology, tumour localization, extent of preoperative neurological deficit and age of the patients were analyzed. Particular respect was given to intraoperative neurophysiological findings.

Results: 57 patients with benign intraspinal tumours underwent surgical resection between 2003 and 2007 at the Nordstadtkrankenhaus Hannover. Patient consisted of 31 males and 26 females, the patient age scored 52 years with a range of 18 up to 82 years. Forty-seven patients (83%) benefit from the procedure and showed postoperativ neurological improvement. Two patients showed postoperative pronounced neurological deficit (3.5%) while 8 patients remained unchanged (14%) . No recurrences were noted during follow up. In 50 cases radical tumour excision was achieved (87.7%), while in 7 cases only a decompression was performed. Outcome and degree of resection closely correlated to the tumour type and localization. While neurinomas and meningiomas demonstrated a very high degree of tumour resection (100% and 96% respectively), intramedullary tumours such as ependymomes and astrocytomas were only radically resected in 80 and 45% respectively. With respect to intraoperative neurophysiology Tibialis SSEP monitoring showed a close correlation with postoperative outcome in neurinomas and meningiomas while it was not helpful in intramedullary tumours such as ependymomas and astrocytomas.

Conclusion: Intraspinal benign tumours are good candidates for microsurgical resection. A very high degree of tumours can be resected completely under preservation of neurological function. However, the outcome as well as the helpfulness of intraoperative neurophysiological monitoring depend on the localization and the histology of the tumours with best results for dural as well as nerve sheath tumours such as menigmiomas and neurinomas.