Intradural Extramedullary Spinal Cord Tumors: A Review Of Literature With Case Presentation

Abstract

Tumors of the spinal canal represent 15% of all CNS tumors. Intradural extramedullary (IDEM)  tumors account for 40 – 45 % of tumors of the spinal canal. These tumors have both sporadic and syndromic patterns of presentation and are generally of benign histology. Meningiomas, schwannomas, neurofibromas, and ependymomas are the commonest entities. These tumors are usually slow growing and present insidiously with axial pain, radicular pain, myelopathy or cauda equina syndrome.  MRI is the diagnostic image of choice.  Because of the predominant benign nature, treatment with radical excision is best to achieve cure while preserving neurologic function, preventing neurologic fall out and maintaining spinal stability. Such surgery can be a challenge considering the limited space for manoeuvrability within the spinal canal. Intraoperative neurophysiologic monitoring can be used during surgery to prevent and detect the occurrence of neurologic injury and is a useful adjunct. We shall review IDEMS with a case illustration.