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Surgery of Intradural Extramedullary Tumors: Retrospective Analysis of 107 Cases

Tarantino, Roberto MD*; Donnarumma, Pasquale MD*; Nigro, Lorenzo MD*; Rullo, Marika PhD; Santoro, Antonio MD*; Delfini, Roberto MD*

doi: 10.1227/NEU.0000000000000513
Research-Human-Clinical Studies

BACKGROUND: Intradural extramedullary tumors (IDEMTs) are uncommon lesions that cause pain and neurological deficits.

OBJECTIVE: To evaluate the effects of surgery for IDEMTs.

METHODS: This cohort study recruited all patients operated on for IDEMTs at the Department of Neurology and Psychiatry of Sapienza University of Rome from January 2003 to January 2013. The analysis was conducted on clinical records evaluation over a 1-year follow-up. The Graphic Rating Scale was used to assess pain. Neurological deficits were detected through neurological examination. Quality of life was evaluated with the EuroQol (EQ-5D). Statistical interpretation of the data was performed with SPSS version 19 software.

RESULTS: One hundred seven patients were recruited. Three were lost to follow-up. Patients reported lower level of pain 1 year after surgery (before surgery, 6.05; after surgery, 3.65). Mean comparison showed a significant decrease of −2.400 (P < .001). Ninety-two patients (88.5%) were neurologically asymptomatic 1 year after surgery. Only 12 patients (11.5%) presented with a deficit, with a global decrease of 39% (χ2 = 27.6; P < .005). The quality of life in patients was middle to high (mean rating of EQ-5D visual analog score, 61.78%). The lowest levels of quality of life were found in patients with sphincter dysfunctions (mean, 33.4).

CONCLUSION: Surgery for IDEMTs has a good outcome. Patients reported lower levels of pain and a drastic reduction in neurological symptoms 1 year after surgery. The quality of life is middle to high. It is influenced mainly by the neurological outcome.

ABBREVIATIONS: EQ-5D VAS, EuroQol visual analog score

GRS, Graphic Rating Scale

IDEMT, intradural extramedullary tumor

*Department of Neurology and Psychiatry, Division of Neurosurgery, and

Department of Psychology of Developmental and Socialization Processes, Sapienza University of Rome, Rome, Italy

Correspondence: Lorenzo Nigro, MD, Department of Neurology and Psychiatry, Division of Neurosurgery, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy. E-mail: nigro86@hotmail.it

Received April 06, 2014

Accepted July 07, 2014

Copyright © by the Congress of Neurological Surgeons