L6: Spinal Tumors

Question 1

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”

Answer 1

…

Question 2

Incidence of Spinal Tumors in Relation to Brain Tumors

Answer 2

Question 3

Prognosis of Spinal Tumors

Answer 3

Question 4

Classification of Spinal Tumors

Answer 4

Question 5

Classification of Spinal Tumors

• Extradural

Answer 5

Question 6

Classification of Spinal Tumors

• Extra-Medullary

Answer 6

Question 7

Classification of Spinal Tumors

• Intra-Medullary

Answer 7

Question 8

Most Common Intramedullary Spinal Tumor

Answer 8

Astrocytoma

Question 9

Radiculopathy VS Myelopathy

Answer 9

Question 10

Examples of Extradural Spinal Tumors

Answer 10

Question 11

Origin of Chordoma

Answer 11

Remnant notochord

Question 12

Behaviour of Chordoma

Answer 12

Question 13

Site of Chordoma

Answer 13

Usually from clivus or sacrum

Question 14

TTT of Chordoma

Answer 14

Question 15

Description of Aneurysmal Bone Cyst

Answer 15

• Expansile tumor with osteolytic activity.
• Consisting of highly vascular Honey comb blood filled cavities surrounded by thin cortical shape.

Question 16

Behaviour of Aneurysmal Bone Cyst

Answer 16

Peak in the 2’d decade of life.

Question 17

Location of Aneurysmal Bone Cyst

Answer 17

Tend to involve the posterior element.

Question 18

TTT of Aneurysmal Bone Cyst

Answer 18

Total excision of the lesion.

Question 19

Examples of Extramedullary Intradural Spinal Tumors

Answer 19

• Meningioma
• Shcwanomma
• Neurofibroma & neurofibromatosis

Question 20

Source of Spinal Meningioma

Answer 20

Arachinoid Cells

Question 21

Behaviour of Spinal Meningioma

Answer 21

Slow growing benign masses

Question 22

Incidence of Spinal Meningioma

Answer 22

• Peak age: From 40-70 years.
• Sex: Female to Male ratio (4:1)

Question 23

Location of Spinal Meningioma

Answer 23

• Mostly intradural - 5% extradural - 5% mixed
• Level: Thoracic (82%) Commenest = Cervical (15%) “ Lumbar (2%)

Question 24

Origin of Spinal Schwanomma

Answer 24

Schwann cells of the sensory rootlets “The tumor only contains Schwann cells”

Question 25

Behaviour of **Spinal Schwanomma**

Answer 25

Benign

Question 26

Incidence of **Spinal Schwanomma**

Answer 26

Question 27

Site of **Spinal Schwanomma**

Answer 27

Question 28

CP of **Spinal Schwanomma**

Answer 28

Question 29

TTT of **Spinal Schwanomma**

Answer 29

Question 30

**Spinal Neurofibroma & neurofibromatosis** is associated with ......

Answer 30

Commonly seen in - Neurofibromatosis type 1 (NF-1) also called von Recklinghausen syndrome

Question 31

Origin of **Spinal Neurofibroma & neurofibromatosis**

Answer 31

Fusiform expansion of the nerve (Schwann - perineural and neural cells)

Question 32

Behavior of **Spinal Neurofibroma & neurofibromatosis**

Answer 32

Benign

Question 33

Location of **Spinal Neurofibroma & neurofibromatosis**

Answer 33

- May be intradural, extradural or dumbbell - Level: Occur more frequently in the cervicalspine in NF-1

Question 34

TTT of **Spinal Neurofibroma & neurofibromatosis**

Answer 34

Difficult to get complete resection, why? - Because of the extraforamenal extension and risk of functional loss

Question 35

Number of **Spinal Neurofibroma & neurofibromatosis**

Answer 35

Often multiple

Question 36

Forms of **Spinal Neurofibroma & neurofibromatosis**

Answer 36

Sometimes plexiform

Question 37

**Spinal Lipoma** is associated with .....

Answer 37

Typically associated with spinal dysraphism.

Question 38

CP of **Spinal Lipoma**

Answer 38

- Present like any space occupying lesion with progressive myelopathy - Onset of symptoms often associated with weight gain,

Question 39

TTT of **Spinal Lipoma**

Answer 39

- Surgical with(debulking of the tumor & duraplasty. - A Must take care not to injure normal spinal cord.

Question 40

Intramedullary Spinal Tumors

Answer 40

- Ependymoma - Astrocytoma

Question 41

Origin of **Spinal Ependymoma**

Answer 41

- Ependymal lining of the central canal. - Filum terminale "usually myxopapillary type".

Question 42

Behaviour of **Spinal Ependymoma**

Answer 42

Very rarely malignant

Question 43

Incidence of **Spinal Ependymoma**

Answer 43

Age: Seen in adults (15 to 40 years). Sex: Male = Female

Question 44

CP of **Spinal Ependymoma**

Answer 44

Question 45

TTT of **Spinal Ependymoma**

Answer 45

Question 46

Origin of **Spinal Astrocytoma**

Answer 46

Astrocyte (Supportive cells)

Question 47

Incidence of **Spinal Astrocytoma**

Answer 47

Age: Any age (average 35 to 40 years).

Question 48

Location of **Spinal Astrocytoma**

Answer 48

Equally throughout the spinal cord.

Question 49

CP of **Spinal Astrocytoma**

Answer 49

- Presenting sign depend upon location. - Most are grade lor Il - Accompanying syrinx in 40%

Question 50

TTT of **Spinal Astrocytoma**

Answer 50