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Postoperative neurological complications in intradural extramedullary tumors: A 10-year experience of a single center
Affiliation:1. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, 431-3192 Hamamatsu-city, Shizuoka, Japan;2. Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192 Hamamatsu-city, Shizuoka, Japan;1. Department of Anesthesiology, The first Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China;2. Department of Neurosurgery, The first Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China;1. Departments of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, India;2. Departments of Neurology, Krishna Institute of Medical Sciences, Secunderabad, India;1. Vanderbilt University, School of Medicine, Nashville, Tennessee, USA;2. Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA;3. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA;4. Department of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Abstract:BackgroundIntradural extramedullary spinal cord tumors (IDEMs) cause neurological symptoms due to compression of the spinal cord and caudal nerves. The purpose of this study was to investigate the incidence of postoperative neurological complications after surgical resection of IDEM and to identify factors associated with such postoperative neurological complications.MethodsWe retrospectively analyzed 85 patients who underwent tumor resection for IDEM between 2010 and 2020. We investigated the postoperative worsening of neurological disorders. The patients were divided into two groups: those with and without postoperative neurological complications. Patient demographic characteristics, tumor level, histological type, and surgery-related factors were also compared.ResultsThe mean age at the time of surgery was 57.4 years, and histological analysis revealed 45 cases of schwannoma, 34 cases of meningioma, three cases of myxopapillary ependymoma, one case of ependymoma, one case of hemangioblastoma and one case of lipoma. There were five cases (5.8%) of postoperative neurological complications, and four patients improved within 6 months after surgery, and one patient had residual worsening. There were no statistically significant differences in age, sex, tumor location, preoperative modified McCormick Scale grade, histology, tumor occupancy, or whether fixation was performed in the presence or absence of postoperative neurological complications. All four cases of meningioma with postoperative neurological complications had preoperative neuropathy and meningiomas were located in the anterior or lateral thoracic spine.ConclusionsNeurological complications after surgical resection for IDEM occurred in 5.8% of patients. Meningiomas with postoperative neurological complications located anteriorly or laterally in the thoracic spine.
Keywords:Intradural extramedullary spinal cord tumors  Neurological complications  Artificial dura mater  Surgical resection  Meningioma
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