TITLE:
Recent Techniques in Management of Lumbosacral Region Tumours: A Prospective Comparative Study
AUTHORS:
Mostafa Abd Elsamea, Mohamed Shaaban, Ahmed Taha
KEYWORDS:
Lambosacral, Lesion, Astrocytoma, Ependymoma
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.8 No.2,
April
27,
2018
ABSTRACT:
Background: The lumbosacral plexus consists of the ventral rami from the L2 to S3
nerve roots, with some additions from the L1 and S4 nerve roots as well. The
standard treatment for spinal cord compression is urgent surgically
decompressive laminectomy over the affected level with resection as much as
possible of the exposed tumor to relieve the cord compression. We aim to
correlate the impact of preoperative clinical picture, duration of symptoms,
and the pathological nature of the lumbo-sacral spine tumors on the outcome of comparative
study different modalities of management. Patients and Methods: During
the period between 2015 and 2017, thirty cases were studied and surgically
managed in Al-Azhar University Hospital, Damietta. Cases were selected for
surgery if they were diagnosed as having a symptomatizing lumbosacral lesion. Results: Thirty patients were included in the current study; the commonest lesion in
this study was ependymoma eight patients (27%), astrocytoma six patients (20%),
and meningioma five patients (17%). Nerve sheath tumor comprised five cases
(17%) with the hemangioblastomas three cases (10%), epidermoid one case (3%),
and ependymoma of the filum terminale two cases (6%). The mean age of the
included patients was 38.96 ± 15.42. The mean duration of lesions was 13.66 ± 10.93.
They were 15 male patients (50%), and 15 female patients (50%), with male:
female ratio 1:1. The mean duration of symptoms ranged for 1:60 months. The
most common presenting manifestations were sensory followed by motor and
sphinctric disturbance. Complications occurred in 8 patients (23%), and the
most common was postoperative CSF leak. 19 out of 30 cases were surgically
totally resected (63%), while 11 cases (37%) were grossly totally resected. Conclusions: Ependymoma and meningioma have more favorable outcome compared to other spinal
tumors. Accurate and rapid diagnosis prior to surgery also associated with good
outcome.