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KMID : 0377619710200060535
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Korean Jungang Medical Journal
1971 Volume.20 No. 6 p.535 ~ p.540
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The Clinical Observation of the Spinal Neurinomas
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Abstract
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Although there are : exhaustive studies of Rasmussen, Kernohan and Adson141, Broager21 and Gautier-Smiths´ on the spinal neurinomas dealt with the clinical features, distribution, results of investigation and surgical treatment, the surgical judgment on the tumor seemed to be quite different in each cases.
The author has attempted to analyze the clinical records of 35 verified spinal neurinomas treated in the Department of Neurosurgery, Yonsei University, Medical Center, over 10 years period.
The spinal neurinomas comprinomas comprised 28% of 125 cases of the spinal cord compression, excluding prolopsed intervertebral disc and tuberculous spondylitis and arachnoiditis.
The incidence of neurinomas in our series is higher than that of Broager´s2), but it corresponds to those reported by Rasmussen et al10´ and Kernohan and Sayre". In contrast meningiomas and gliomas are much less frequent in our series compared to previous reports.
The spinal neurinomas occured predominantly in 3rd to 6th decade of age and males (22) were more affected than females (13). Alt the 5 cases of dumbbell neurinomas in our series occurred in female.
The clinical course was chronic and progressive, ranged mostly from 2 months to 6 years.
No particular location of the spinal cord was predilected this series, but thetumor was most commonly situated intradurally (31) and dorsal (30) to the spinal cord. Two cases of foramen magnum tumors were directed intracranilly.
The clinical symptoms and signs of neurinomas were not different from other benign spinal cord tumors, but sensory cord symptoms usually preceded the motor cord symptoms.
An enlargement of the intervertebral foramen and a shadow of the extravertebral part of the dumb-bell neurinoma on plain X-ray studies were the most significant finding in the diagnosis of spinal dumb-bell neurinomas.
Pantopaque myelography was a confirmatory diagnostic aid, in cases with complete subarachnoid blockage a new irrigation technique was developed and supplied to those cases to remove the intrathecal contrast dye.
The higher level of spinal fluid protein was suggestive intradural tumors or tumors located in the lower level of the spinal canal.
The choice of surgery is principally a decompressive laminectomy with complete removal of the tumor but in cases when the tumor was too large and had dangers to ruinthe normal spinal cord milien a decompression only was better attempted.
31 cases (88.5%) of our series were improved by surgery.
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