L6: Spinal Tumors Flashcards
Spinal tumors are one of the challenging issues in neurosurgery why?
- As they are present in a potentially narrow space containing neural tissue.
So they are mostly presented by neural deficits “Necessitating rapid, meticulous intervention to prevent further complications to the patient”
…
Incidence of Spinal Tumors in Relation to Brain Tumors
Prognosis of Spinal Tumors
Classification of Spinal Tumors
Classification of Spinal Tumors
- Extradural
Classification of Spinal Tumors
- Extra-Medullary
Classification of Spinal Tumors
- Intra-Medullary
Most Common Intramedullary Spinal Tumor
Astrocytoma
Radiculopathy VS Myelopathy
Examples of Extradural Spinal Tumors
Origin of Chordoma
Remnant notochord
Behaviour of Chordoma
Site of Chordoma
Usually from clivus or sacrum
TTT of Chordoma
Description of Aneurysmal Bone Cyst
- Expansile tumor with osteolytic activity.
- Consisting of highly vascular Honey comb blood filled cavities surrounded by thin cortical shape.
Behaviour of Aneurysmal Bone Cyst
Peak in the 2’d decade of life.
Location of Aneurysmal Bone Cyst
Tend to involve the posterior element.
TTT of Aneurysmal Bone Cyst
Total excision of the lesion.
Examples of Extramedullary Intradural Spinal Tumors
- Meningioma
- Shcwanomma
- Neurofibroma & neurofibromatosis
Source of Spinal Meningioma
Arachinoid Cells
Behaviour of Spinal Meningioma
Slow growing benign masses
Incidence of Spinal Meningioma
- Peak age: From 40-70 years.
- Sex: Female to Male ratio (4:1)
Location of Spinal Meningioma
- Mostly intradural - 5% extradural - 5% mixed
- Level: Thoracic (82%) Commenest = Cervical (15%) “ Lumbar (2%)
Origin of Spinal Schwanomma
Schwann cells of the sensory rootlets “The tumor only contains Schwann cells”
Behaviour of Spinal Schwanomma
Benign
Incidence of Spinal Schwanomma
Site of Spinal Schwanomma
CP of Spinal Schwanomma
TTT of Spinal Schwanomma
Spinal Neurofibroma & neurofibromatosis is associated with ……
Commonly seen in
- Neurofibromatosis type 1 (NF-1) also called von Recklinghausen syndrome
Origin of Spinal Neurofibroma & neurofibromatosis
Fusiform expansion of the nerve (Schwann - perineural and neural cells)
Behavior of Spinal Neurofibroma & neurofibromatosis
Benign
Location of Spinal Neurofibroma & neurofibromatosis
- May be intradural, extradural or dumbbell
- Level: Occur more frequently in the cervicalspine in NF-1
TTT of Spinal Neurofibroma & neurofibromatosis
Difficult to get complete resection, why?
- Because of the extraforamenal extension and risk of functional loss
Number of Spinal Neurofibroma & neurofibromatosis
Often multiple
Forms of Spinal Neurofibroma & neurofibromatosis
Sometimes plexiform
Spinal Lipoma is associated with …..
Typically associated with spinal dysraphism.
CP of Spinal Lipoma
- Present like any space occupying lesion with progressive myelopathy
- Onset of symptoms often associated with weight gain,
TTT of Spinal Lipoma
- Surgical with(debulking of the tumor & duraplasty.
- A Must take care not to injure normal spinal cord.
Intramedullary Spinal Tumors
- Ependymoma
- Astrocytoma
Origin of Spinal Ependymoma
- Ependymal lining of the central canal.
- Filum terminale “usually myxopapillary type”.
Behaviour of Spinal Ependymoma
Very rarely malignant
Incidence of Spinal Ependymoma
Age: Seen in adults (15 to 40 years).
Sex: Male = Female
CP of Spinal Ependymoma
TTT of Spinal Ependymoma
Origin of Spinal Astrocytoma
Astrocyte (Supportive cells)
Incidence of Spinal Astrocytoma
Age: Any age (average 35 to 40 years).
Location of Spinal Astrocytoma
Equally throughout the spinal cord.
CP of Spinal Astrocytoma
- Presenting sign depend upon location.
- Most are grade lor Il
- Accompanying syrinx in 40%
TTT of Spinal Astrocytoma
