Original Article
Journal of Korean Neurosurgical Society. 1985; 14(2): 355-366.
A Clinical Study of the Spinal Cord Tumor.
Jin Yang Joo, Young Soo Kim, and Kyu Chang Lee
Department of Neurosurgery, Yonsei University, College of Medicine, Seoul, Korea.
ABSTRACT
To provide a guideline of accurate diagnosis and proper methods of treatment of spinal cord tumor the author analyzed 83 cases of spinal cord tumor who had been operated at the Department of Neurosurgery of Yonsei University College of Medicine during last 10 old years. The results were summerized as follows ; 1) The ratio of male to female was 1.6: 1 and 41% of the 83 patients were in the 4th and 5th decade. 2) The most common histopathologic type was neurinoma(48.2%), and the rests were metastatic tumor(15.7%), astrocytoma(9.6%), and ependymoma(4.8%). The distribution of the tumors was thoracic(50.6%), cervical(26.5%), and lumbosacral (20.5%). The location of the tumors was intradural extramedullary(48.2%), extradural(25.3%), and intramedullary(19.3%). 3) The common clinical features were pain, motor disturbance, sensory disturbance, and sphincter disturbance. In radiologic diagnostic tests, there were abnormal findings in 49.3% of plain X-rays. The entire 77 cases of myelography showed subarachnoid blockade. The computerized tomographic metrizamide myelography(CTMM), regarded as the most accurate diagnostic method, showed the exact location of the tumor and the relationship of the tumor with the spinal cord and the dura in entire 8 cases. 4) Thirty six neurinomas(90%) and all 8 meningiomas(100%) could be excised totally. In 30 neurinomas(75%) and 5 meningiomas(62.5%), the patients regained their motor function postopratively. In 37 neurinomas(92.5%) and 8 meningiomas(100%), the patients' sphincter function was recovered. The results of operation were particulary excellent in the cases with neurinoma and meningioma. 5) Among the 10 astrocytomas, total excision was performed in 2 cases, and decompressive laminectomy with biopsy was performed in 4 cases. Postoperative radiotherapy was performed in 4 cases. Postoperative radiotherapy was performed in 2 cases. 6) Among the 3 intramedullary ependymomas, total excision was possible in 2 cases. Subtotal excision was performed in a case with caudal ependymoma. 7) In 9 metastatic tumors, primary tumors of which were unknown preoperatively, and in 3 metastatic tumors in which the stability of the spine was deranged, surgical treatment was performed. In 3 cases, radiation therapy was followed postoperatively.
Keywords : Spinal cord tumor;Meurinoma;Meningioma;Astrocytoma;Ependymoma;Metastatic tumor;Computerized tomographic metrizamide myelography;Laminectomy;Radiotherapy