Skip to main content

Intradural Extramedullary Lesions

  • Chapter
  • First Online:
Spine Surgery
  • 99k Accesses

Abstract

Intradural extramedullary lesions are tumors arising within the dura but outside the actual spinal cord and account for 40% of all spinal tumors. Among these, meningeomas (33%) and tumors of spinal nerves (27%) are the most common. Spinal meningeomas most frequently occur in the posterior or lateral thoracic region, followed by anterior cervical region and lumbosacral region. Clinical symptoms develop through an impairment of neural elements and pathways, producing both local and distal effects. Early diagnosis and adequacy of surgical intervention are the key determinants for the best long-term prognosis and preservation of neurological integrity. A complete and safe tumor removal and decompression of the spinal cord are the primary goals of surgery. Standard minimally-invasive posterior or posterolateral approaches provide an adequate exposure for a safe tumor removal in the majority of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Duong LM, et al. Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004–2007. Cancer. 2012;118(17):4220–7. (EBM level: III).

    Article  Google Scholar 

  2. Traul DE, Shaffrey ME, Schiff D. Part I: spinal-cord neoplasms–intradural neo-plasms. Lancet Oncol. 2007;8(1):35–45. (Evidence level II, recommendation level B).

    Article  Google Scholar 

  3. Solero CL, et al. Spinal meningiomas: review of 174 operated cases. Neurosurgery. 1989;25(2):153–60. (EBM level: III, recommendation level C).

    Article  CAS  Google Scholar 

  4. Goldbrunner R, Minniti G, Preusser M, et al. EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol. 2016;17(9):e383–91. (Evidence level II, recommendation level B).

    Article  Google Scholar 

  5. Wong A, Lall R, Dahdaleh N, et al. Comparison of open and minimally invasive surgery for intradural-extramedullary spine tumors. Neurosurg Focus. 2015;39:E11. (EBM level: III, recommendation level C).

    Article  Google Scholar 

  6. Angevine PD, Kellner C, Haque RM, McCormick PC. Surgical management of ventral intradural spinal lesions. J Neurosurg Spine. 2011;15(1):28–37. (EBM level: III, recommendation level C).

    Article  Google Scholar 

  7. Lee RR. MR Imaging of intradural tumors of the cervical spine. Magn Reson Imaging Clin N Am. 2000;8(3):529–40. (EBM level: III, recommendation level C).

    CAS  PubMed  Google Scholar 

  8. Gottfried ON, Gluf W, Quinones-Hinojosa A, Kan P, Schmidt MH, et al. Spinal meningiomas: surgical management and outcome. Neurosurg Focus. 2003;14(6):1–7. (EBM level: III, recommendation level B).

    Article  Google Scholar 

  9. Tsuda K, Akutsu H, Yamamoto T, Nakai K, Ishikawa E, Matsumura A. Is Simpson grade I removal necessary in all cases of spinal meningioma? Assessment of postoperative recurrence during long-term follow-up. Neurol Med Chir. 2014;54:907–13. (EBM level: III, recommendation level B).

    Article  Google Scholar 

  10. Avila MJ, Walter CM, Skoch J, Abbasifard S, Patel AS. Fusion after intradural spine tumor resection in adults: a review of evidence and practices. Clin Neurol Neurosurg. 2015;138:169–73. (EBM level: III, recommendation level C).

    Article  Google Scholar 

  11. Tredway TL, Santiago P, Hrubes MR, Song JK, Christie SD, Fessler RG, et al. Minimally invasive resection of intradural extramedullary spinal neoplasms. Oper Neurosurg. 2006;58(1):52–7. (EBM level: II, recommendation level B).

    Google Scholar 

  12. Parsa AT, Lee J, Parney IF, Weinstein P, McCormick P, Ames C. Spinal cord and intradural-extraparenchymal spinal tumors: current best care practices and strategies. J Neuro-Oncol. 2004;69:291–318. (EBM level: II, recommendation level B).

    Article  Google Scholar 

  13. Roux FX, Nataf F, Pinaudeau M, Borne G, Devaux B, Mender JF, et al. Intraspinal meningiomas: review of 54 cases with discussion of poor prognosis factors and modern therapeutic management. Surg Neurol. 1996;46:458–64. (EBM level: III, recommendation level C).

    Article  CAS  Google Scholar 

  14. Klekamp J, Samii M. Surgical results for spinal meningiomas. Surg Neurol. 1999;52:552–62. (EBM level: III, recommendation level C).

    Article  CAS  Google Scholar 

  15. McCormick PC, Post KD, Stein BM. Intradural extramedullary tumors in adults. Neurosurg Clin N Am. 1990;1(3):591–608. (EBM level: III, recommendation level C).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peter Vajkoczy .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Zdunczyk, A., Vajkoczy, P. (2019). Intradural Extramedullary Lesions. In: Meyer, B., Rauschmann, M. (eds) Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98875-7_68

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-98875-7_68

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98874-0

  • Online ISBN: 978-3-319-98875-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics