Surgical outcomes following intradural extramedullary spinal tumour resection - a single centre retrospective review.

Background

Intradural extramedullary (IDEM) spinal tumours are predominantly benign lesions for which surgical resection remains the mainstay of treatment. This study evaluates the epidemiology, surgical management, and outcomes over 10 years at a tertiary neurosurgical centre.

Methods

A retrospective review was conducted of adult patients undergoing surgery for IDEM tumours at Leeds General Infirmary between April 2011 and March 2021. Demographics, clinical presentation, tumour characteristics, management and outcomes were analysed.

Results

Ninety-five patients were included, mean age was 53 years; 57% were female. Median follow-up was 93 months. Most patients (72.6%) presented with ASIA grade D neurology. Tumours were predominantly thoracic (42.1%) or lumbar (32.6%), with schwannomas (32.7%) and meningiomas (24.2%) being the most common histologies.Gross total resection was achieved in 73.7%. Neurological function improved in 35.8% of patients and was preserved in 60%. The complication rate was 13.7%. Spinal fixation and laminoplasty were performed in 4.2% and 10.5% of cases, respectively. Adjuvant therapy was used in 10.5%. Recurrence or progression occurred in 8.4%.

Conclusion

Surgical resection of IDEM tumours achieves favourable neurological outcomes, with most patients improving or remaining stable. Gross total resection remains the surgical goal, while prioritising neurological preservation. Long-term surveillance remains important given the risk of recurrence.