{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:15:25Z","timestamp":1793297725775,"version":"4.5.0"},"reference-count":31,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of benign intraspinal neoplasms. These are amenable to gross total excision but can have variable functional outcomes, which plays a key role in assessing their impact on a patient\u2019s quality of life. Understanding the functional outcomes associated with these tumors is crucial for healthcare professionals to devise appropriate treatment plans and provide comprehensive care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>In this study, we retrospectively reviewed the outcomes of 130 patients with IDEM tumors who underwent surgery in the past six years between January 2017 and December 2022 at a single institution. Patient demographics, symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel grading. The back pain was assessed using the Denis pain scale (DPS).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>The age range, gender distribution, presentation, histopathology, and tumor characteristics were analyzed. The histopathological outcomes of the study were as follows: 56 cases of schwannoma, 37 cases of meningiomas, 16 patients of neurofibroma, six cases of epidermoid cyst, five cases each of ependymoma and dermoid cyst, three cases of arachnoid cyst, two cases of metastasis, and one case of paraganglioma. Pain was the most common symptom (38.5%), followed by weakness in limbs (31.5%), paresthesia\/numbness (22.3%), and sphincter disturbance (7.7%). Complete total resection was seen in 93% of cases, with 7% undergoing subtotal excision. The complications encountered were \u2013 four cases of surgical site infection and one case each of cerebrospinal fluid leak, pseudomeningocele, and epidural hematoma. In our series, 49.3% of patients had significantly good improvement in functional outcomes as per improvement in Frankel score, and 43% of patients had good functional improvement. Significant functional improvement was noted at immediate postoperative follow-up, 2-week follow-up, and six-month follow-up periods. Reoccurrence was seen in 7 cases (5.4%). The DPS score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significantly poor outcome was seen in IDEM tumours present anteriorly.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>The IDEM tumors are usually benign and are readily detected by contrast-enhanced magnetic resonance imaging scans. These have variable functional outcomes in different centers. Assessing this functional outcome is an essential aspect of managing IDEM spinal tumors. It was observed through our study that the ventral location of the tumor, thoracic tumors, and poor preoperative neurological status of the patient correspond with poorer postoperative functional outcomes. Furthermore, a significant decrease in the pain symptoms with improvement of Frankel score was seen postoperatively, thus this being suggestive of a significant improvement of functional outcome after surgery. This study helps to conclude that the morbidity associated with the resection of IDEM tumors is not as significant as originally thought to be.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_689_2023","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T08:32:22Z","timestamp":1712305942000},"page":"114","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Functional outcomes in intradural extramedullary spinal tumors"],"prefix":"10.25259","volume":"15","author":[{"given":"Anmol Singh","family":"Randhawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiteez","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra Singh","family":"Verma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhawani Shankar","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tshering Dorjee","family":"Sherpa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"key":"10.25259\/SNI_689_2023\/ref-1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s00234-007-0345-7","article-title":"Intradural spinal tumors: Current classification and MRI features","volume":"50","author":"Abul-Kasim","year":"2008","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_689_2023\/ref-2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.4184\/jkss.2003.10.3.277","article-title":"A 6-year observation of multiple spinal schwannomas before excision-1 case report","volume":"10","author":"Ahn","year":"2003","journal-title":"J Korean Soc Spine Surg"},{"key":"10.25259\/SNI_689_2023\/ref-3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4055\/cios.2009.1.3.165","article-title":"The surgical treatment for spinal intradural extramedullary tumors","volume":"1","author":"Ahn","year":"2009","journal-title":"Clin Orthop Surg"},{"key":"10.25259\/SNI_689_2023\/ref-4","doi-asserted-by":"crossref","first-page":"291","DOI":"10.4103\/1793-5482.162707","article-title":"Spinal tumors: Trends from Northern India","volume":"10","author":"Arora","year":"2015","journal-title":"Asian J Neurosurg"},{"key":"10.25259\/SNI_689_2023\/ref-5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/sj.sc.3101394","article-title":"Clinical features associated with recurrence of tumours of the spinal cord and cauda equina","volume":"41","author":"Asazuma","year":"2003","journal-title":"Spinal Cord"},{"key":"10.25259\/SNI_689_2023\/ref-6","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.3349\/ymj.2014.55.4.1063","article-title":"Combined muscle motor and somatosensory evoked potentials for intramedullary spinal cord tumour surgery","volume":"55","author":"Choi","year":"2014","journal-title":"Yonsei Med J"},{"key":"10.25259\/SNI_689_2023\/ref-7","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.3390\/jpm13071103","article-title":"Is there a role for intraoperative neuromonitoring in intradural extramedullary spine tumors? results and indications from an institutional series","volume":"13","author":"D\u2019Ercole","year":"2023","journal-title":"J Pers Med"},{"key":"10.25259\/SNI_689_2023\/ref-8","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.clinph.2007.09.135","article-title":"Intraoperative neurophysiological monitoring of the spinal cord during spinal cord and spine surgery: A review focus on the corticospinal tracts","volume":"119","author":"Deletis","year":"2008","journal-title":"Clin Neurophysiol"},{"key":"10.25259\/SNI_689_2023\/ref-9","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/00003086-198410000-00015","article-title":"Acute thoracolumbar burst fractures in the absence of neurologic deficit a comparison between operative and nonoperative treatment","volume":"189","author":"Denis","year":"1984","journal-title":"Clin Orthop Relat Res"},{"key":"10.25259\/SNI_689_2023\/ref-10","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1080\/02688699943042","article-title":"Spinal intradural tumours: Part I-extramedullary","volume":"13","author":"El-Mahdy","year":"1999","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_689_2023\/ref-11","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1590\/0004-282X20140008","article-title":"Complete removal of the spinal nerve sheath tumors. 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