Spinal Cord Tumors : An Analysis of 175 Cases(1973-1986)

ABSTRACT

The authors analyzed 175 cases of spinal cord tumor who had been operated upon at the Department of Neurosurgery of the Seoul National University Hospital from 1973 to 1986. The tumor was most common in the 5th decade of age(47 cases, 26.9%) and 24 cases(13.7%) were children. And the ratio of male to female was 1.21. The pathologic diagnosis was neurogenic tumor in 73 cases(41.7%), metastatic tumor in 29 cases(16.6%), glial tumor in 24 cases(13.7%), and meningeal tumor in 23 cases(13.1%) in the order of frequency, and the tumors of dysembryogenesis were only 2 cases(1.1%). The tumors were located most frequently in the thoracic area(79 cases, 45.1%) and I the intradural extramedullary space(79 cases, 45.1%). The most common initial presentation was pain(86 cases, 49.1%) and the mean duration of presentation was 20.6 months. On admission 70 cases(40.0%) were in the 'paraparesis stage'. The mean value of the CSF protein was 741mg%. The rate of positivity of the plain spinal radiologic study was 55.7% and the most common positive findings was the increased interpedicular distance(46 cases, 29.1%). the total or gross total removal was possible in 105 cases (60.0%). The surgical result within the postoperative one month was recovery in 52 cases(29.7%), improvement in 76 cases(43.4%), stationary state in 36 cases (20.6%), progression in 11 cases(6.3%). After 20.1 months of the mean follow-up duration in 109 cases(62.3%), the result was recovery in 69 cases(63.3%), improvement in 16 cases(14.7%), stationary state in 8 cases(7.3%), progression in 16 cases(14.7%). As a major complication, there was a spinal deformity in 6 cases(3.4%), pulmonary embolism in 2 cases(1.1%), postoperative hematoma and meningitis in 1 case(0.6%) each. Ten cases(5.7%) were followed up to their deaths. And the authors discussed the clinical features of the spinal cord tumors reported in the literatures and the results of the present study with a more detailed consideration on each of major pathologies, neurogenic tumors, meningeal tumors, glial tumors, and metastatic tumors.