Spinal Neurogenic Tumors: Outcome after Resection of the Involved Nerve Root

ABSTRACT

OBJECTIVE: The aim of this study is to determine the treatment strategies for spinal neurogenic tumor involving nerve root and to evaluate the outcome after resection of the root. METHODS: The retrospective review of 76 cases of spinal cord tumors, operated between 1992-2001, was done. We underwent surgery for 22 cases of spinal neurogenic tumors with somatosensoty evoked potential monitoring. Resection of the affected nerve root was necessary in 15 cases for complete removal of the tumor. In six patients of these the resected nerve root was relevant for upper or lower limb function and five patients underwent end to end anastomosis. RESULTS: There were 12 men and 10 women and the mean age was 43 years. The tumors were located most frequently in the lumbar area(7 cases, 31.8%). The most common initial symptoms were radiating pain(18 cases, 81.8%) and mean duration of presentation was 39.3 weeks. In all cases, tumor was removed totally except one case of schawannoma which is dumbbell-shaped and huge extradural extension to retroperitoneal cavity. The postoperative outcomes on discharge were improved in 16 cases(72.7%). Among 15 cases of tumor resection together with involving nerve root, 13 cases(86.7%) were improved. All the cases performed end to end neural anastomosis were inproved. CONCLUSION: The results indicate that resection of the involved nerve root usually do not produce neurological deficit and complete removal of tumor with the involved nerve root is one of the appropriate and safe procedure. Also, end to end anastomosis of resected nerve root contribute to the chance of regeneration and functional recovery.