- 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)
- commonly arises in the conus medullaris
- tends to be a discrete lesion which can be excised;
- 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.
Orthopaedic aspects of intraspinal tumors in infants and children.