Retrospective Experiences in Spinal Tumor Surgery: Heading for New Perspectives and Future Insights

Abstract

Aim: Spinal tumours have benign characteristics, and constitute nearly 10-25 % of central nervous system tumours. Locations, growth rates, and cellular types of spinal tumours, and the techniques applied are important prognostic parameters. This study examined the effects of accurate diagnosis, appropriate approach, emergency action, microsurgery and operation techniques on prognosis.

Materials and Methods: Radiologically diagnosed and surgically confirmed hospital records of 119 cases who were operated in our clinics between January 2000 and December 2010 were investigated. Retrospective analysis of the cases was conducted by recording data on age, and gender of the patient together with location, symptomatology, surgical and histological grade, and stage of the tumor q. Sharp tumoral dissection, electrocauterization, blood transfusion, foreign body applications, local drug use, and instrumentations were avoided A drain was used for the cases included in the present study. Gadolinium-enhanced MRG scan was performed in all cases, postoperatively. Diagnoses were confirmed by postoperative histopathological examinations. The cases were analyzed using clinical parametres, radiological and other laboratory findings and the results of the discussion were recorded. Possible reasons for the positive and negative results, rarely seen in the spinal surgery, were investigated retrospectively and anterospectively.

Results: Of 119 cases, 50.4 % were female and 49.6 % were male. Tumours were found in thoracal (57.9 %), lumbosacral (26.2 %) and cervical (15.9 %) locations. While extradural tumours (51.3 %) were by far the most common spinal tumours, the frequency of intradural extramedullary, and intramedullary tumours were 38.6 %, and 10.1 %, respectively. Half of the extradural tumours were of metastatic type. Other extradural masses were primary spinal tumours. Meningioma was the most common type of intradural tumour. During the post-operative follow-ups, non-specific pain and dysesthesia disappeared in almost all cases, but neurological deficit resolved only in 9 patients.

Conclusions: In tumour surgery, due to the possibility of vasomotor and autonomic dysfunctions, high voltage monopolar cautery should not be used unless necessary.