{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T18:35:41Z","timestamp":1770402941899,"version":"3.49.0"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Adult primary spinal tumors (PST) are under-reported, particularly in low- and middle-income countries, including Pakistan. Notably, despite the limited availability of Intraoperative neurophysiological monitoring (IONM), we safely managed 137 patients with spinal cord tumors at a tertiary center over 10 years.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We retrospectively reviewed demographic, neurological status (i.e., evaluation using Modified McCormick Scale preoperatively\/postoperatively), surgical outcomes, and progression-free survival (PFS) for 137 patients operated for primary spinal cord tumors over 10 years.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n These 137 patients with mean age 40.8 \u00b1 15.1 years were followed up for an average of 8.7 months after surgery. Pre-operative common symptoms included lower extremity weakness (61, 44.5%) and back pain (50, 36.5%). Tumors were located mainly in the cervical (49, 36.6%) and thoracic spine (43, 32.1%). With IONM use in 29 (21.5%) patients, gross total resection (GTR; 25 [86.2%]) was achieved for the majority of tumors. IONM was not available for 106 patients. Of the latter, 90 (85.0%) had GTR. Notably, GTR was the only significant predictor of PFS (\n P<\/jats:italic>\n = 0.03). At last follow-up, MMS improved in 97 (70.8%) of patients, was unchanged in 25 (18.2%), and worsened in 15 (11.0%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n We found in Pakistan that many of the 137 patients with spinal cord tumors presented late in their clinical course, often with significant neurological deficits; this highlights the need for earlier and better diagnostic capacity and referral pathways. Despite limited IONM availability due to limited resources, GTR rates and neurological improvement were achieved. Nevertheless, we still advocate using IONM where resources allow.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1332_2025","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T07:29:41Z","timestamp":1770362981000},"page":"65","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and surgical outcomes of adult primary spinal cord tumors: A 10-year experience"],"prefix":"10.25259","volume":"17","author":[{"given":"Fareeha","family":"Nisar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qurat-ul-Ain","family":"Virani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quratulain","family":"Mohib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saqib Kamran","family":"Bakhshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Shahzad","family":"Shamim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"10.25259\/SNI_1332_2025\/ref-1","doi-asserted-by":"crossref","first-page":"e220","DOI":"10.1016\/j.wneu.2021.05.081","article-title":"The utility of multimodal intraoperative neuromonitoring in spine surgery: Case series from a lower-middle-income country perspective","volume":"152","author":"AlMahdy","year":"2021","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1332_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.3390\/jcm14051671","article-title":"Systematic review comparing open versus minimally invasive surgical management of intradural extramedullary tumours (IDEM)","volume":"14","author":"Baig Mirza","year":"2025","journal-title":"J Clin Med"},{"key":"10.25259\/SNI_1332_2025\/ref-3","doi-asserted-by":"crossref","first-page":"598619","DOI":"10.3389\/fneur.2020.598619","article-title":"Management of extramedullary intradural spinal tumors: The impact of clinical status, intraoperative neurophysiological monitoring and surgical approach on outcomes in a 12-year double-center experience","volume":"11","author":"Cofano","year":"2020","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_1332_2025\/ref-4","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s11060-024-04623-4","article-title":"Clinical presentation and extent of resection impacts progression-free survival in spinal ependymomas","volume":"167","author":"Davison","year":"2024","journal-title":"J NeuroOncol"},{"key":"10.25259\/SNI_1332_2025\/ref-5","doi-asserted-by":"crossref","first-page":"6251","DOI":"10.3390\/cancers14246251","article-title":"Current knowledge on spinal meningiomas epidemiology, tumor characteristics and non-surgical treatment options: A systematic review and pooled analysis (part 1)","volume":"14","author":"El-Hajj","year":"2022","journal-title":"Cancers"},{"key":"10.25259\/SNI_1332_2025\/ref-6","doi-asserted-by":"crossref","first-page":"130","DOI":"10.25259\/SNI_44_2020","article-title":"Barriers of neurophysiology monitoring in spine surgery: Latin America experience","volume":"11","author":"Guiroy","year":"2020","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1332_2025\/ref-7","first-page":"e89320","article-title":"Current approach and predictors of clinical outcomes in adults with spinal ependymomas","volume":"17","author":"Hern\u00e1ndez-Hern\u00e1ndez","year":"2025","journal-title":"Cureus"},{"key":"10.25259\/SNI_1332_2025\/ref-8","doi-asserted-by":"crossref","first-page":"3047","DOI":"10.1007\/s00701-022-05350-3","article-title":"Intramedullary spinal cord and filum tumours-long-term outcome: Single institution case series","volume":"164","author":"Myrseth","year":"2022","journal-title":"Acta Neurochir (Wein)"},{"key":"10.25259\/SNI_1332_2025\/ref-9","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10143-018-0957-x","article-title":"Intradural spinal tumors in adults-update on management and outcome","volume":"42","author":"Ottenhausen","year":"2019","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_1332_2025\/ref-10","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/B978-0-12-819826-1.00019-3","article-title":"Intraoperative neurophysiology in intramedullary spinal cord tumor surgery","volume":"186","author":"Sala","year":"2022","journal-title":"Handb Clin Neurol"},{"key":"10.25259\/SNI_1332_2025\/ref-11","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s11060-007-9507-z","article-title":"Descriptive epidemiology of primary spinal cord tumors","volume":"87","author":"Schellinger","year":"2007","journal-title":"J NeuroOncol"},{"key":"10.25259\/SNI_1332_2025\/ref-12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3171\/2013.11.PEDS13346","article-title":"Quality of life after surgical treatment of primary intramedullary spinal cord tumors in children","volume":"13","author":"Schneider","year":"2014","journal-title":"J Neurosurg Pediatr"}],"container-title":["Surgical Neurology 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