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Resection of a lumbar intradural tumor – Lumbar Spinal Stenosis

The article summarizes a case report of a 64-year-old male with a lumbar intradural tumor. The patient presented with lower extremity weakness, pain, and bowel/bladder dysfunction. Magnetic resonance imaging confirmed the presence of a large L3-5 intradural lesion. Surgical resection was performed using intraoperative neuromonitoring techniques such as somatosensory evoked potentials, motor evoked potentials, free-running electromygraphy, and direct sphincter monitoring. The tumor was debulked and successfully removed through a piecemeal resection, achieving gross total resection. The use of adjunctive techniques such as intraoperative ultrasound was beneficial. The patient recovered well postoperatively and the final pathology revealed the tumor to be a paraganglioma. The study emphasizes the importance of early intervention and complete tumor resection for optimal outcomes in spinal intradural tumors

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSION: Early intervention and gross total resection of spinal intradural tumors are associated with optimal patient outcomes. Additional adjuncts, such as ultrasound, are beneficial and can help achieve gross total tumor resection.

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Surg Neurol Int. 2023 Oct 20;14:377. doi: 10.25259/SNI_770_2023. eCollection 2023.ABSTRACTBACKGROUND: Myxopapillary ependymomas and schwannomas represent the most common tumors of the conus medullaris and cauda equina. Here, we present the surgical resection of a 64-year-old male with a lumbar intradural tumor.CASE DESCRIPTION: A 64-year-old male presented with several months of the lower extremity weakness, pain,

Surg Neurol Int. 2023 Oct 20;14:377. doi: 10.25259/SNI_770_2023. eCollection 2023.

ABSTRACT

BACKGROUND: Myxopapillary ependymomas and schwannomas represent the most common tumors of the conus medullaris and cauda equina. Here, we present the surgical resection of a 64-year-old male with a lumbar intradural tumor.

CASE DESCRIPTION: A 64-year-old male presented with several months of the lower extremity weakness, pain, and bowel/bladder dysfunction. Magnetic resonance imaging demonstrated a large L3-5 intradural lesion, and surgical resection using intraoperative neuromonitoring with somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), free-running electromygraphy (EMGs), and direct sphincter monitoring was recommended. After an L2-S1 laminectomy was performed, intraoperative ultrasound was used to confirm the cranial and caudal extent of the tumor. The dural was opened using a midline approach, and the tumor was quickly visualized. Through careful dissection, the tumor was debulked and gross total resection was ultimately achieved through a piecemeal resection. Hemostasis was frequently required throughout the case, as the tumor was highly vascular. Postoperatively, the patient was at his neurologic baseline and was discharged to rehab on postoperative day 4. The final pathology revealed the intradural lesion was a paraganglioma.

CONCLUSION: Early intervention and gross total resection of spinal intradural tumors are associated with optimal patient outcomes. Additional adjuncts, such as ultrasound, are beneficial and can help achieve gross total tumor resection.

PMID:37941626 | PMC:PMC10629344 | DOI:10.25259/SNI_770_2023

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Resection of a lumbar intradural tumor

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Surg Neurol Int. 2023 Oct 20;14:377. doi: 10.25259/SNI_770_2023. eCollection 2023.ABSTRACTBACKGROUND: Myxopapillary ependymomas and schwannomas represent the most common tumors of the conus medullaris and cauda equina. Here, we present the surgical resection of a 64-year-old male with a lumbar intradural tumor.CASE DESCRIPTION: A 64-year-old male presented with several months of the lower extremity weakness, pain

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