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Chapter-106 Spinal Cord Tumors

BOOK TITLE: Textbook of Contemporary Neurosurgery (2 Volumes)

Author
1. Nayyar Tanuj
2. Kandallu Suresh Bapu R
ISBN
9789350252390
DOI
10.5005/jp/books/11681_106
Edition
1/e
Publishing Year
2012
Pages
12
Author Affiliations
1. Apollo BGS Hospital, Mysore, Karnataka, India
2. Apollo Specialty Hospitals, Chennai, Tamil Nadu, India
Chapter keywords

Abstract

Spinal cord tumors are less common than the intracranial tumors and rarer in children. Similarly, some intradural tumors may extend through the nerve root sleeve into the extradural compartment. They are listed in this chapter. Extra and intramedullary tumors are discussed in this chapter. The most common site spinal cord tumors is the cervical area followed by thoracic and then conus. In adults, ependymoma is the most common intramedullary tumor and in children astrocytomas predominate. Most spinal cord ependymomas have a more indolent course compared with those in the posterior fossa or supratentorial region. Rare subependymomas in the spinal cord are symptomatic, unlike their counterparts in the ventricular system. Benign myxopapillary subtype is almost exclusively seen in the filum terminale. Astrocytomas include the circumscribed astrocytomas, such as the pilocytic astrocytoma (most common in children) and the infiltrating astrocytomas. Most extramedullary tumors are solitary schwannomas from dorsal nerve root, suspended eccentrically from it with a discrete attachment. Extramedullary meningiomas are more common in middle aged women and in the thoracic region. Meningiomas (rare in childhood) rise from arachnoid cap cells near the root sleeve (ventral/ventrolateral) position with broad dural attachment which needs to be excised to prevent recurrence. Surgery is the mainstay in the treatment, preferably with intraoperative neuromonitoring. The outcome following surgery for extramedullary and intramedullary ependymomas, hemangioblastomas and cavernomas is good. Prognostic factors for patients with spinal cord intramedullary gliomas are very similar to that of the histologically identical lesions found in the brain and duration of symptoms prior to diagnosis.

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