- Intrameduallary tumors:
- infiltrate or compress the spinal cord so gradually that they may grow to considerable size before detection;
- are glial in origin (except for the rare hemangioblastoma)
- ependymomas:
- commonly arises in the conus medullaris
- tends to be a discrete lesion which can be excised;
- astrocytomas
- potential for malignant degeneration resembling cerebral GBM;
- extremely difficult/impossible to excise
- Intradural, Extramedullary tumors:
- usually benign, slow growing, and well circumscribed
- arise from the swan cells of the proximal nerve roots
- spinal meningiomas occur 10x more frequently in women;
- may be completely excised, usually not radiosensitive;
- include benign meningioma and neurilemmoma and
neurofibroma;
- local and radicular pain is an early symptom;
- spinal cord deficit develops gradually & is often not dx'ed until
Brown Sequard Syndrome deficit becomes evident;
- myeography demonstates the tumor;
- nerve roots in the thoracic region may be sectioned for better exposure, but damage to radicular arteries must be avoided;
The treatment of primary vertebral tumors by radical resection and prosthetic vertebral replacement.
Primary neoplasms of the cervical spine. Diagnosis and treatment of twenty-three patients.
Primary tumors of the spine.
JN Weinstein and RF McLain.
Spine Vol 12. 1987 p 843-851.
Orthopaedic aspects of intraspinal tumors in infants and children.
MO Tachdjian and DD Matson.
JBJS. Vol 47-A. 1965. p 223-248.
Intramedullary spinal cord tumors presenting as scoliosis.
N. Citron et al.
JBJS. Vol 1984-B. Vol 66-B. p 513-517.
