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Clinical features and surgical outcomes of primary cauda equina tumours

  • Clinical Article - Spine
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Abstract

Background

To identify clinical features, radiological findings and surgical outcomes of primary cauda equina tumours.

Methods

A consecutive series of 64 operations in 60 patients with primary cauda equina tumours from April 1999 to May 2009 at one institution comprised the study. The cases were divided into tumours of neural sheath origin (TNS, n = 48) and tumours of non-neural sheath origin (TNNS, n = 22). We analysed pain intensity, neurological abnormalities, MRI findings, surgical extent and functional outcome.

Results

The TNS group showed more leg pain (76 % vs. 44 %, p = 0.019) with higher intensity (6.1 ± 1.5 vs. 4.6 ± 1.9, p = 0.04). Motor weakness and bladder dysfunction were more common in the TNNS group (p = 0.028 and p = 0.00 in each). Flow voids of MRI were more frequently observed in TNNS (50 % vs. 4 %, p = 0.01). The TNS group achieved total removal in all operations compared with total removal in 77 % in the TNNS group (p = 0.001). The TNNS group showed higher recurrence rates (18 % vs. 0 %, p = 0.009). The TNS group showed higher improvement of JOA scores postoperatively (p = 0.049). Surgical complications were observed less frequently in the TNS group (19 % vs. 78 %, p = 0.000).

Conclusions

TNS differs from TNNS by causing more frequent leg pain, higher pain intensity and more frequent flow voids. TNS has better surgical outcomes than TNNS in terms of higher rates of total removal, fewer surgical complications, better functional outcomes and less recurrence.

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References

  1. Araki Y, Ishida T, Ootani M, Yamamoto H, Yamamoto T, Tsukaguchi I, Nakamura H (1993) MRI of paraganglioma of the cauda equina. Neuroradiology 35(3):232–233

    Article  PubMed  CAS  Google Scholar 

  2. Asazuma T, Toyama Y, Suzuki N, Fujimura Y, Hirabayshi K (1999) Ependymomas of the spinal cord and cauda equina: an analysis of 26 cases and a review of the literature. Spinal Cord 37(11):753

    Article  PubMed  CAS  Google Scholar 

  3. Calenbergh F, Plets C, Ardon H, Sciot R (2011) Paraganglioma of the cauda equina region: a report of three cases. Surg Neurol Int 2(1):96

    Article  PubMed  Google Scholar 

  4. Celli P, Cervoni L, Salvati M, Cantore G (1997) Recurrence from filum terminale ependymoma 42 years after 'total' removal and radiotherapy. J Neurooncol 34(2):153–156

    Article  PubMed  CAS  Google Scholar 

  5. Chang I-C (2004) Surgical experience in symptomatic congenital intraspinal cysts. Pediatr Neurosurg 40(4):165–170

    Article  PubMed  Google Scholar 

  6. Escott EJ, Kleinschmidt-DeMasters BK, Brega K, Lillehei KO (2004) Proximal nerve root spinal hemangioblastomas: presentation of three cases, MR appearance, and literature review. Surg Neurol 61(3):262–273, discussion 273

    Article  PubMed  Google Scholar 

  7. Han I-H, Kuh S-U, Chin D-K, Kim K-S, Jin B-H, Cho Y-E (2008) Surgical treatment of primary spinal tumors in the conus medullaris. J Korean Neurosurg Soc 44(2):72–77

    Article  PubMed  Google Scholar 

  8. HogenEsch RI, Staal MJ (1988) Tumors of the cauda equina: the importance of an early diagnosis. Clin Neurol Neurosurg 90(4):343–348

    Article  PubMed  CAS  Google Scholar 

  9. Jeon JH, Hwang HS, Jeong JH, Park SH, Moon JG, Kim CH (2008) Spinal Schwannoma; analysis of 40 Cases. J Korean Neurosurg Soc 43(3):135–138

    Article  PubMed  Google Scholar 

  10. Lapierre F, Bataille B, Vandermarcq P, Goujon JM, Wager M, Page P (1999) Cauda equina tumors in adults. Neurochirurgie 45(1):29–38

    PubMed  CAS  Google Scholar 

  11. Nadkarni TD, Menon RK, Desai KI, Goel A (2006) Hemangioblastoma of the filum terminale. J Clin Neurosci 13(2):285–288

    Article  PubMed  Google Scholar 

  12. Shimada Y, Miyakoshi N, Kasukawa Y, Hongo M, Ando S, Itoi E (2006) Clinical features of cauda equina tumors requiring surgical treatment. Tohoku J Exp Med 209(1):1–6

    Article  PubMed  Google Scholar 

  13. Shin DA, Kim SH, Kim K-N, Shin HC, Yoon D-H (2008) Surgical management of spinal cord haemangioblastoma. Acta Neurochir (Wien) 150(3):215–220, discussion 220

    Article  CAS  Google Scholar 

  14. Shin DA, Kim SH, Kim KN, Shin HC, Yoon DH (2007) Spinal cord tumors of the thoracolumbar junction requiring surgery: a retrospective review of clinical features and surgical outcome. Yonsei Med J 48(6):988–993

    Article  PubMed  Google Scholar 

  15. Singh NG, Sarkar C, Sharma MC, Garg A, Gaikwad SB, Kale SS, Mehta VS (2005) Paraganglioma of cauda equina: report of seven cases. Brain Tumor Pathol 22(1):15–20

    Article  PubMed  Google Scholar 

  16. Wager M, Lapierre F, Blanc JL, Listrat A, Bataille B (2000) Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review of the literature. Neurosurg Rev 23(3):119–129, discussion 130–1

    Article  PubMed  CAS  Google Scholar 

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Acknowlegments

This study was supported by a grant from the Korea Healthcare Technology R&D project, Ministry for Health & Welfare Affairs, Republic of Korea (A111016).

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Authors and Affiliations

  1. Department of Neurosurgery, Yonsei University College of Medicine, Shinchon-dong 134, Seoul, Republic of Korea, 120-752

    Dong Ah Shin, Joong Won Yang, Seong Yi, Yoon Ha, Do Heum Yoon & Keung Nyun Kim

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  1. Dong Ah Shin
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  2. Joong Won Yang
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  3. Seong Yi
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  4. Yoon Ha
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  5. Do Heum Yoon
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  6. Keung Nyun Kim
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Corresponding author

Correspondence to Keung Nyun Kim.

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Shin, D.A., Yang, J.W., Yi, S. et al. Clinical features and surgical outcomes of primary cauda equina tumours. Acta Neurochir 155, 1911–1916 (2013). https://doi.org/10.1007/s00701-013-1792-z

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  • DOI: https://doi.org/10.1007/s00701-013-1792-z

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