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Clinical features and surgical outcomes of primary cauda equina tumours

 Dong Ah Shin  ;  Joong Won Yang  ;  Seong Yi  ;  Yoon Ha  ;  Do Heum Yoon  ;  Keung Nyun Kim 
 ACTA NEUROCHIRURGICA, Vol.155(10) : 1911-1916, 2013 
Journal Title
Issue Date
Adult ; Aged ; Cauda Equina/diagnostic imaging ; Cauda Equina/pathology ; Cauda Equina/surgery* ; Female ; Humans ; Lumbar Vertebrae/pathology ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Pain/etiology ; Pain Measurement ; Peripheral Nervous System Neoplasms/diagnostic imaging ; Peripheral Nervous System Neoplasms/pathology ; Peripheral Nervous System Neoplasms/surgery* ; Postoperative Complications/prevention & control ; Radiography ; Treatment Outcome
Differential diagnoses ; Treatment outcome ; Surgery ; Cauda equina ; Spinal cord neoplasms
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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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Yi, Seong(이성)
Ha, Yoon(하윤)
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