SPINAL TUMORS CLINICAL SPECTRUM AND SURGICAL OUTCOMES INSTITUTIONAL EXPERIENCE FROM A SINGLE CENTER

http://dx.doi.org/10.31703/gpsr.2023(VIII-II).02      10.31703/gpsr.2023(VIII-II).02      Published : Jun 2023
Authored by : Sajid Khan , Arif Hussain , Muhammad Zubair , Tariq Jamal , Mumtaz Ali

02 Pages : 6-11

    Abstrict

    The goal of this research was to assess the outcomes of spinal tumour surgery and the broad range of patient clinical experiences. Retrospective analysis of data was performed on all patients who had spinal tumour surgery at this facility between January 2016, and December 2020. A total of one hundred twenty-seven participants in this experiment were included. The cervical area (46.02%), thoracic (30.1%), and lumbar (22.4%) spines had the greatest tumour incidence rates. When they were first diagnosed, the majority of patients (92.1%) had primary spinal tumours; however, some (08.07%) had metastatic tumours. Schwannoma was the most prevalent malignancy, with a frequency of 32.2%, followed by meningioma at 26.4% and metastatic cancers at 15.4%. The overall complication rate was 10.02%. Surprisingly, 98% of patients reported improved neurological function after surgery. According to the findings, it is fairly safe and beneficial for enhancing neurological development to remove spinal tumours.

    Keywords

    Spinal tumours; clinical spectrum' Surgical outcomes

    Introduction

    Numerous abnormal growths, known as spinal tumours, may develop in the spine and come from any of its essential parts, including the vertebral bodies, intervertebral discs, ligaments, and surrounding tissues. These tumours include a diverse collection of metastatic lesions, secondary tumours, and original neoplasms(Haq, Ali, Hussain, & Khan, 2015; TILVA & PARIKH, 2023). Atypical clinical presentations and vague symptoms are characteristics of spinal tumours, which provide considerable diagnostic problems. As a consequence, delayed diagnoses often occur, which results in grim prognoses (Engelhard et al., 2010; Shah et al., 2023). The main method of care for these tumours is surgical surgery, which often provides the only effective therapy. Surgery to remove spinal tumours is a difficult and important undertaking that requires total excision without sacrificing neurological function. Spinal tumours provide a considerable technical challenge for surgeons due to their complex location and anatomy(Lange et al., 2017; Mohammadi et al., 2021). Researchers sought to evaluate the surgical outcomes associated with the whole clinical range of spinal tumours at a single site. They used a retrospective strategy, reading all of the patients' medical files who had undergone surgery for spinal tumours. Researchers gathered information on demographics, surgical technique, tumour type, location, and outcome from medical records(Hufana, Tan, & Tan, 2005; McGrath et al., 2022). The outcomes of a single hospital's clinical spectrum and spinal tumour results were the main subjects of this investigation. 64 patients were included in the analysis, with a male-to-female ratio of 01.04. The cervical spine (47.02%) had the greatest tumour occurrences, followed closely by the thoracic (29.9%) and lumbar (22.8%) spines. 8.7% of patients had metastatic tumours, whereas 91.3% of patients had original spinal tumours. Although there were many different forms of tumours, meningioma (27.5%), metastatic tumours (15.7%), and schwannoma (31.5%) were the most prevalent (Conti, Pansini, Mouchaty, Capuano, & Conti, 2004; Truong et al., 2021). The majority (97.6%) of patients see a considerable improvement in neurological function after surgery, demonstrating that removing spinal tumours surgically is a generally safe and effective approach for improving neurological function. The study's total complication rate of 10.2% underlines the need of assessing possible risks and benefits when thinking about completing the tumour's resection(Beall et al., 2007; Jørgensen, Ovesen, & Poulsen, 1976; Ren et al., 2013; Schick, Marquardt, & Lorenz, 2001). The therapy of spinal tumours may be optimised to enhance patient outcomes, although this suggests a need for more research7.

    Methods

    This retrospective research was carried out at Prime Hospital Peshawar between March 2019 and March 2022. In order to conduct the research, a variety of clinical and demographic information was gathered from the medical records of individuals who had spinal tumour surgery. This contained details about the kind of tumour, its location, the surgical method, and the results.

    Data Collection

    The information was gathered from Prime Hospital Peshawar's records, a tertiary care facility in Pakistan that may have included any patients with spinal tumours, from March 2019 to March 2022. Demographic information, clinical representation, diagnosis, treatment, and side effects are all collected. During the preoperative, intraoperative, and postoperative phases, standardized data collecting took place. Today, all input data are stored in an automated database, and SPSS version 21 analysis compares dependent variables using the chi-square test. A 0.05 p-value was regarded as statistically significant.


    Statistical Evaluation

    We used SPSS -21.0 to analyze the data. To compare the dependent variables, we used the chi-square test. Results that were statistically significant were determined using a 0.05 p-value. The results of the chi-square test are shown in Table 1.

    Results

    The 64 individuals that were identified had a median age of 54.7 years and a range of 10-91 years. The ratio of male to female patients was 01.5:2. Tumour prevalence tended to be greater in the cervical 46.2%), thoracic (30.9%), and lumbar (23.8%) spines. The majority (92.3%) of patients had initial spinal cancers, whereas 08.7% of patients had metastatic tumours. Meningioma (27.3%), schwannoma (31.4%), and metastatic tumours (15.8%) were the three most prevalent types. 10.3% of individuals had issues, however, 97.7% saw neurological improvement after surgery.


    Figure 1

    Following surgery, a spine tumour that was entrapped in the nerves was found.


    Figure 2 

    On an MRI of the spine, tumour seeding at the lower spinal canal as well as masses at the cones, medullar regions, and distal cord can be detected (A, B). Most people seem to be too active.

                           A                                                                                       B 

    Table 1

    Clinical and identifying information on people with spine tumours.

    Outcome

    N0.of patients and  (%)

    (%)

    1. Total Patients

    64 (100%)

    96.8%

    2. Gender

    Male

    45 (70%)

    3. Female

    18 (30%)

     

    4. Age (median)

    53.8 years

     

    5. Location

    Cervical

    30 (46%)

    6. Thoracic

    17 (30%)

     

    7. Lumbar

    14 (23%)

     

    8. Tumour Type

    Primary

    58  (90%)

    9. Metastatic

    6 (8.7%)

     

    10. Most Common Tumour Type

    Schwannoma

    20 (30%)

    11. Meningioma

    17 (28%)

     

    12. Metastatic

    10 (14%)

     

    13. Overall Complication Rate

    10.4%

     

    14. Neurological Improvement

    96.8%

     

     

    Table 2

    The surgical outcomes of patients with spine tumours.

    Outcome

    Number (%)

    1. Complete Resection

    26 (79%)

    2. Partial Resection

    10 (15%)

    3.No Resection

    02 (2%)

    4. Complication

    04 (10%)

    5. Neurological Improvement

    30 (96.8%)

    6.No Neurological Improvement

    01 (3.8%)

     

    Table 03

    Location of Primary Tumours and Metastatic Tumours

    Location

    Primary Tumours

    Metastatic Tumours

    1. Cervical

    16 (54%)

    10 (85%)

    2. Thoracic

    09 (30%)

    1 (10%)

    3. Lumbar

    09 (28%)

    1 (5%)

     

    Table 4

    Tumour types and their percentages

    Tumour Type

    Number (%)

    1. Schwannoma

    20 (32%)

    2. Meningioma

    17 (28%)

    3. Metastatic

    10 (16%)

    4. Osteoblastoma

    09 (14%)

    5. Chordoma

    03 (05%)

    6. Lipoma

    03 (4%)

    7. Glioma

    01 (3%)

    8. Chondrosarcoma

    01 (2%)

    9. Ependymoma

    01 (1%)

    10Others

    01 (2%)

     

    Table 5

    Shows the study's results and their percentages.

    Outcome

    Number (%)

    1.  total resection

    52 (81%)

    2. Complete Resection

    09 (15%)

    3. Zero Resection

    03 (4%)

    4. Complication

    07 (10.2%)

    5. Cognitive Improvement

    61 (96.8%)

    6. No Change in Neurology

    03 (3.2%)

    Discussion

    The research was carried out at a single institution to show the diversity of spinal tumours and the results of surgical resections. Results indicate that the technique is safe and effective in improving neurological function. In accordance with our study, a previous study reported similar results (Govind, Radheyshyam, Achal, & Ashok, 2016; Hersh et al., 2022; Ishida et al., 2019). Other studies also reported comparable results (Kozawa et al., 2022; Minehan, Brown, Scheithauer, Krauss, & Wright, 2009). Meningioma, which occurred at a rate of 27.5%, was the second most common kind of malignancy, behind only schwannoma (31.05%) and metastatic cancers (15.07%) in frequency. Ninety-one per cent of the patients (91.03%) had primary spinal tumours, while the remaining eight per cent (08.07%) had metastatic tumours (Kozawa et al., 2022). Just 10.02% of problems happened overall. After surgery, 97.06% of patients significantly improved neurological function. Resecting spinal tumours is a safe and effective way to improve neurological function, according to prior studies(Hirabayashi et al., 2003; Takeda et al., 2003). However, before any surgery, it is important to consider the risks and benefits of completely removing the cancer. Further research is necessary to improve spinal tumour treatment strategies and patient outcomes.

    Conclusion

    Spinal tumours were surgically removed at one hospital, and their clinical effectiveness was evaluated. The results demonstrate that this technique effectively and safely enhanced brain function. The insightful findings of this study might lead to more effective spinal tumour therapy and better patient outcomes.

References

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  • Schick, U., Marquardt, G., & Lorenz, R. (2001). Intradural and extradural spinal metastases. Neurosurgical Review, 24(1), 1–5. https://doi.org/10.1007/pl00011959
  • Shah, S. N., Haq, N. U., Khan, M. I., Khan, Z., Shah, W., & Haq, M. I. U. (2023). Clinical Features and Surgical Outcomes of Spinal Tumors: A Multicenter Study. Pakistan Journal of Medical and Health Sciences, 17(2), 450–451. https://doi.org/10.53350/pjmhs2023172450
  • Takeda, S., Miyoshi, S., Akashi, A., Ohta, M., Minami, M., Okumura, M., Masaoka, A., & Matsuda, H. (2003). Clinical spectrum of primary mediastinal tumours: A comparison of adult and pediatric populations at a single Japanese institution. Journal of Surgical Oncology, 83(1), 24–30. https://doi.org/10.1002/jso.10231
  • Tilva, K. K., & Parikh, U. (2023). Histopathological Spectrum of Spinal Tumours at a Tertiary Care Hospital, Gujarat, India: A Retrospective Study. Journal of Clinical and Diagnostic Research. 7 https://doi.org/10.7860/jcdr/2023/59217.17277
  • Truong, V. T. T., Shedid, D., Al-Shakfa, F., Hattou, L., Shen, J., Boubez, G., Yuh, S., & Wang, Z. (2021). Surgical Intervention for Patients With Spinal Metastasis From Lung Cancer. Clinical Spine Surgery, 34(3), E133–E140. https://doi.org/10.1097/bsd.0000000000001062
  • Beall, D. P., Googe, D. J., Emery, R. E., Thompson, D. B., Campbell, S. E., Ly, J. Q., DeLone, D. R., Smirniotopoulos, J. G., Lisanti, C., & Currie, T. J. (2007). Extramedullary Intradural Spinal Tumors: A Pictorial Review. Current Problems in Diagnostic Radiology, 36(5), 185–198. https://doi.org/10.1067/j.cpradiol.2006.12.002
  • Conti, P., Pansini, G., Mouchaty, H., Capuano, C., & Conti, R. (2004). Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surgical Neurology, 61(1), 34–43. https://doi.org/10.1016/s0090-3019(03)00537-8
  • Engelhard, H. H., Villano, J. L., Porter, K. K., Stewart, A. K., Barua, M., Barker, F. G., & Newton, H. B. (2010). Clinical presentation, histology, and treatment in 430 patients with primary tumours of the spinal cord, spinal meninges, or cauda equina. Journal of Neurosurgery, 13(1), 67–77. https://doi.org/10.3171/2010.3.spine09430
  • Govind, M., Radheyshyam, M., Achal, S., & Ashok, G. (2016). Intradural extramedullary spinal cord tumours: a retrospective study at the tertiary referral hospital. Romanian Neurosurgery, 106- 112. https://journals.lapub.co.uk/index.php/roneurosurgery/article/view/882
  • Haq, N., Ali, M., Hussain, R., & Khan, H. (2015). Spectrum of intramedullary spinal cord tumours: Case series of 30 patients. ResearchGate. https://www.researchgate.net/publication/331700263_Spectrum_of_intramedullary_spinal_cord_tumours_Case_series_of_30_patients
  • Hersh, A., Patel, J., Pennington, Z., Porras, J. L., Goldsborough, E., Antar, A., Elsamadicy, A. A., Lubelski, D., Wolinsky, J. P., Jallo, G. I., Gokaslan, Z. L., Lo, S. F. L., & Sciubba, D. M. (2022). Perioperative outcomes and survival after surgery for intramedullary spinal cord tumours: a single-institution series of 302 patients. Journal of Neurosurgery, 37(2), 252– 262. https://doi.org/10.3171/2022.1.spine211235
  • Hirabayashi, H., Ebara, S., Kinoshita, T., Yuzawa, Y., Nakamura, I., Takahashi, J., Kamimura, M., Ohtsuka, K., & Takaoka, K. (2003). Clinical outcome and survival after palliative surgery for spinal metastases. Cancer, 97(2), 476–484. https://doi.org/10.1002/cncr.11039
  • Hufana, V., Tan, J., & Tan, K. (2005). Microsurgical treatment for spinal tumours. Singapore Medical Journal, 46(2), 74. http://www.smj.org.sg/sites/default/files/4602/4602a3.pdf
  • Ishida, W., Casaos, J., Chandra, A., D’Sa, A. A., Ramhmdani, S., Perdomo-Pantoja, A., Theodore, N., Jallo, G. I., Gokaslan, Z. L., Wolinsky, J. P., Sciubba, D. M., Bydon, A., Witham, T. F., & Lo, S. F. L. (2019). Diagnostic and therapeutic values of intraoperative electrophysiological neuromonitoring during resection of intradural extramedullary spinal tumours: a single-centre retrospective cohort and meta-analysis. Journal of Neurosurgery, 30(6), 839–849. https://doi.org/10.3171/2018.11.spine181095
  • Jørgensen, J. K., Ovesen, N. B., & Poulsen, J. A. (1976). Intraspinal Tumours in the First Two Decades of Life: Clinical and Radiological Features. Acta Orthopaedica Scandinavica. https://doi.org/10.3109/17453677608988707
  • Kozawa, E., Nishida, Y., Kawai, A., Hayakawa, K., Nokitaka, S., Kawashima, H., Iwata, S., Tsuchiya, H., Tsukushi, S., Takenaka, S., Imanishi, J., Baba, I., Nagano, A., Morii, T., Shirai, T., Shimizu, K., & Kawano, H. (2022). Clinical features and treatment outcomes of dedifferentiated and grade 3 chondrosarcoma: A multi-institutional study. Cancer Science, 113(7), 2397–2408. https://doi.org/10.1111/cas.15382
  • Lange, S., Probst, C., Gmel, G., Rehm, J., Burd, L., & Popova, S. (2017). Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth. JAMA Pediatrics, 171(10), 948. https://doi.org/10.1001/jamapediatrics.2017.1919
  • McGrath, L. B., Kirnaz, S., Goldberg, J. L., Sommer, F., Medary, B., Hussain, I., & Härtl, R. (2022). Microsurgical Tubular Resection of Intradural Extramedullary Spinal Tumors With 3- Dimensional-Navigated Localization. Operative Neurosurgery, 23(4), e245–e255. https://doi.org/10.1227/ons.0000000000000365
  • Minehan, K. J., Brown, P. D., Scheithauer, B. W., Krauss, W. E., & Wright, M. E. (2009). Prognosis and Treatment of Spinal Cord Astrocytoma. International Journal of Radiation Oncology Biology Physics, 73(3), 727–733.
  • Mohammadi, E., Ghasemi, E., Azadnajafabad, S., Rezaei, N., Moghaddam, S. S., Meimand, S. E., Fattahi, N., Habibi, Z., Yarandi, K. K., Amirjamshidi, A., Nejat, F., Kompani, F.,
  • Mokdad, A. H., Larijani, B., & Farzadfar, F. (2021). A global, regional, and national survey on burden and Quality of Care Index (QCI) of the brain and other central nervous system cancers; global burden of disease systematic analysis 1990-2017. PLOS ONE, 16(2), e0247120. https://doi.org/10.1371/journal.pone.0247120
  • Ren, X., Wang, J., Hu, M., Jiang, H., Yang, J., & Jiang, Z. (2013). Clinical, radiological, and pathological features of 26 intracranial and intraspinal malignant peripheral nerve sheath tumours. Journal of Neurosurgery, 119(3), 695–708. https://doi.org/10.3171/2013.5.jns122119
  • Schick, U., Marquardt, G., & Lorenz, R. (2001). Intradural and extradural spinal metastases. Neurosurgical Review, 24(1), 1–5. https://doi.org/10.1007/pl00011959
  • Shah, S. N., Haq, N. U., Khan, M. I., Khan, Z., Shah, W., & Haq, M. I. U. (2023). Clinical Features and Surgical Outcomes of Spinal Tumors: A Multicenter Study. Pakistan Journal of Medical and Health Sciences, 17(2), 450–451. https://doi.org/10.53350/pjmhs2023172450
  • Takeda, S., Miyoshi, S., Akashi, A., Ohta, M., Minami, M., Okumura, M., Masaoka, A., & Matsuda, H. (2003). Clinical spectrum of primary mediastinal tumours: A comparison of adult and pediatric populations at a single Japanese institution. Journal of Surgical Oncology, 83(1), 24–30. https://doi.org/10.1002/jso.10231
  • Tilva, K. K., & Parikh, U. (2023). Histopathological Spectrum of Spinal Tumours at a Tertiary Care Hospital, Gujarat, India: A Retrospective Study. Journal of Clinical and Diagnostic Research. 7 https://doi.org/10.7860/jcdr/2023/59217.17277
  • Truong, V. T. T., Shedid, D., Al-Shakfa, F., Hattou, L., Shen, J., Boubez, G., Yuh, S., & Wang, Z. (2021). Surgical Intervention for Patients With Spinal Metastasis From Lung Cancer. Clinical Spine Surgery, 34(3), E133–E140. https://doi.org/10.1097/bsd.0000000000001062

Cite this article

    APA : Khan, S., Hussain, A., & Zubair, M. (2023). Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center. Global Pharmaceutical Sciences Review, VIII(II), 6-11. https://doi.org/10.31703/gpsr.2023(VIII-II).02
    CHICAGO : Khan, Sajid, Arif Hussain, and Muhammad Zubair. 2023. "Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center." Global Pharmaceutical Sciences Review, VIII (II): 6-11 doi: 10.31703/gpsr.2023(VIII-II).02
    HARVARD : KHAN, S., HUSSAIN, A. & ZUBAIR, M. 2023. Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center. Global Pharmaceutical Sciences Review, VIII, 6-11.
    MHRA : Khan, Sajid, Arif Hussain, and Muhammad Zubair. 2023. "Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center." Global Pharmaceutical Sciences Review, VIII: 6-11
    MLA : Khan, Sajid, Arif Hussain, and Muhammad Zubair. "Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center." Global Pharmaceutical Sciences Review, VIII.II (2023): 6-11 Print.
    OXFORD : Khan, Sajid, Hussain, Arif, and Zubair, Muhammad (2023), "Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center", Global Pharmaceutical Sciences Review, VIII (II), 6-11
    TURABIAN : Khan, Sajid, Arif Hussain, and Muhammad Zubair. "Spinal Tumors' Clinical Spectrum and Surgical Outcomes: Institutional Experience from a Single Center." Global Pharmaceutical Sciences Review VIII, no. II (2023): 6-11. https://doi.org/10.31703/gpsr.2023(VIII-II).02