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NATIONAL CENTER FOR NEUROSURGERY

Extra and intramedullary spinal cord tumor

Extra and intramedullary spinal cord tumor.

Clinically, spinal tumors are divided depending on the location relative to the dura mater in three main groups: intradural-extramedullary, intramedullary, and extradural.

Intradural - extramedullary tumors develop from spinal membranes ( meningioma ) , in the nerve roots that emerge from the spinal cord ( schwannomas and neurofibromas ) or spinal cord ( ependymomas terminal filament ). Although meningiomas are often benign, they can be difficult to remove, and tend to recue . Tumors of the nerve roots are also usually benign, although neurofibromas may eventually malignize. Ependymoma of the terminal filament spinal cord can reach enormous sizes, and treatment is complicated by the complex nature of neural structures relations in this area.

Intramedullary tumors grow within the spinal cord or individual nerves, most commonly found in the cervical region. They usually develop from glial or ependymal cells. Astrocytomas and ependymomas are the two most common types of tumors. They are often benign, but difficult to remove. Intramedullary lipoma - a rare congenital tumor, usually ranging in the thoracic spinal cord

Extradural lesion, usually associated with metastatic cancer or schwannomas originating from the cell membranes of nerve roots. Sometimes extradural tumor spread through the intervertebral foramen and are partially inside and partially outside the spinal canal (according to the "hourglass").

Symptoms

Back pain, in particular in the middle or lower back, is the most common symptom, both benign and malignant tumors of the spinal cord. This back pain is not associated with trauma , stress or physical activity. However, the pain may be aggravated by movement and more intense at night. The pain may extend beyond the back: on the thigh , leg , hand or foot and may increase over time, even when treated with conservative , non-surgical methods that are commonly used for back pain caused by non-tumor diseases (radiculitis, lumbodynia etc.).

Depending on the location and type of tumor other symptoms of damage may occur, especially if the cancer grows and presses on the spinal cord, nerve roots, grow into blood vessels or bones of the spine. Compression of the spinal cord tumor is an extremely dangerous complication. May include the following symptoms :

  • Violation of the sensitivity of the legs, arms or chest.
  • The difficulty of movements, clumsiness .
  • Reduced sensitivity to pain, heat and cold .
  • Violation of bowel and bladder.
  • Paralysis of various areas of the body, which emphasized the level depending on the spinal cord or nerves.
  • Scoliosis or other spinal deformities as a result of a large but benign tumor.

Methods of treatment:

  •  Microsurgical removal of the bulk of education spinal cord and vertebral column
  •  Decompressive-stabilizing operations with the use of pedicle designs, interbody cages and other implants