Neuromonitoring of Spinal Intradural Extramedullary Lesions

Mohamed, Samy Hasanin; Elmesallamy, Wael Abd Elrahman; Yakout, Hesham Ahmed; Elsheikh, Magdy Omar

doi:10.21608/ejhm.2023.288382

Neuromonitoring of Spinal Intradural Extramedullary Lesions

Document Type : Original Article

Authors

10.21608/ejhm.2023.288382

Abstract

Background: Intraoperative neuromonitoring for intramedullary tumours is now a common procedure in neurosurgery, however it remains controversial whether it is appropriate for intradural extramedullary tumours.
Objective: The aim of this study is to evaluate the role of intraoperative neuromonitoring during surgery for intradural extramedullary tumors.
Patients and methods: This study included 15 patients with intradural extramedullary tumors who underwent microsurgical resection guided by intraoperative neuromonitoring at Neurosurgery Department, Zagazig University Hospitals. Neurological status on admission and at follow-up was assessed using the Modified McCormick Scale. Results: Cases mainly presented with motor symptoms (66.6%). Twenty percent of cases had sphincter abnormality and 13.3% had only sensory symptoms. Complete gross total excision of the lesion was accomplished in 73.3% of cases, 13.3% of cases had near total removal, 1 case (6.6%) had subtotal resection and in 1 case (6.6%) only biopsy was taken. Modified McCormick grading at follow-up (minimum 6 months) after surgery, showed improved grade in 80% of the studied cases.
Conclusion: The use of intraoperative neuromonitoring during surgery for intradural extramedullary tumors was useful. It enabled a safer tumor manipulation in challenging case such as lesions at the cranio-vertebral junction or in antero/antero-lateral positions (where the rotation of the spinal cord may be observed), as well as tumors adherent to the spinal cord without a visible cleavage plane.

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