Efficacy of Surgery in Intradural Extramedullary Spinal Cord Tumors and Factors Affecting Prognosis

INTRODUCTION: Intradural extramedullary spinal cord tumors (IDEMSTs), albeit rare, can severely impair quality of life, mobility, and survival. They represent 15% of central nervous system tumors. Early discovery, effective treatment, and better outcomes require understanding these tumors. Our study investigated IDEMSTs predictive variables and clinical features. We aimed to improve the management of IDEMSTs by examining age, gender, initial symptoms, clinical history, comorbidities, smoking habits, preoperative and postoperative neurological states, tumor location and size, pathological diagnosis, and surgical complications.
METHODS: Our analysis included 51 IDEMST patients who underwent surgery at our clinic. Demographics, presenting symptoms, time intervals between symptom onset, diagnosis, and surgery, comorbidities, smoking habits, preoperative and early postoperative neurological examinations, tumor location and size, surgical procedure, extent of tumor resection, pathological diagnosis, surgical complications, length of hospitalization, and preoperative and early postoperative assessment scales were evaluated. These factors were examined to determine surgical efficacy, patient outcomes, and prognosis.
RESULTS: Older patients had worse recovery rates and Karnofsky scores. Additionally, longer hospital stays were linked to worse neurological conditions. Neurological functions improved better in early surgery patients. Ependymoma patients had better pre- and post-op neurological functioning, while meningioma and thoracic tumor patients improved significantly. However, thoracic tumor patients had severe neurological impairments. Males showed better pre- and post-op neurological status. Lower severity and duration of symptoms before surgery also increased postoperative neurological improvement. Our data indicate that demographic, tumor-specific, morphological, and functional neurological variables can affect IDEMST surgical efficiency.
DISCUSSION AND CONCLUSION: Surgical excision is safe and effective for these IDEMSTs. Our study identifies the impact of age, tumor level, pathology, Karnofsky score, Nurick scale, and gender on surgical outcomes. Nevertheless, prospective studies on larger scales are required. These studies may allow for a more comprehensive evaluation of the prognostic factors affecting IDEMST surgery and produce more reliable results.