Clinical profile and outcome of surgical management of intramedullary spinal cord tumours: A single center study in a developing country

Toyin Ayofe Oyemolade; James Ayokunle Balogun; Oluwakemi Aderonke Badejo; Adefolarin Obanisola Malomo; Matthew Temitayo Shokunbi; Olusola Kayode Idowu; Augustine Abiodun Adeolu

doi:10.1016/j.wnsx.2023.100228

Clinical profile and outcome of surgical management of intramedullary spinal cord tumours: A single center study in a developing country

World Neurosurg X. 2023 Jun 21:20:100228. doi: 10.1016/j.wnsx.2023.100228. eCollection 2023 Oct.

Authors

Affiliations

¹ Department of Neurological Surgery, University College Hospital, UCH, PMB 5116, Ibadan, Oyo State, Nigeria.
² Division of Neurosurgery, Department of Surgery, Federal Medical Centre, PMB 1053, Owo, Ondo State, Nigeria.
³ Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
⁴ Department of Anaesthesia, College of Medicine University, University of Ibadan, Ibadan, Oyo State, Nigeria.

Abstract

Objective: There is as yet a paucity of data on intramedullary spinal cord tumours (IMSCTs) in sub-Saharan Africa. This study aims to define the clinical profile and outcome of management of IMSCTs in a Nigerian tertiary hospital.

Methods: This is a retrospective study of all the patients who had surgery for IMSCTs in our hospital over a 14 year period.

Results: There were 20 patients, 9 males, 11 females, in this study. The median age was 33 years (range = 7-78 years). The median duration of symptoms was 12 months (range = 1-120 months). Motor deficit was present in all but one (95%) of our patients. Only 25% of the patients presented in good functional status (McCormick grades I and II). The tumours were confined to the thoracic region in 10 patients (50%), while tumours in the thoracic region extending to the adjoining cervical and lumbar regions were seen in 6 patients (30%). Gross total tumour resection was achieved in 60% of the patients and subtotal resection in the remaining 40%. Astrocytoma and ependymoma were the most common tumours, each occurring in 35% of the cases. Six patients (30.0%) improved, 12 patients (60.0%) remained neurologically the same, while 2 patients (10.0%) deteriorated at the time of last follow up. The mortality rate was 15%. The preoperative functional status was a significant predictor of postoperative outcome (p = 0.03).

Conclusion: Astrocytoma and ependymoma were the most common histological tumour types among our patients. Late presentation and poor pre-operative functional status were prominent features of our patients' cohort.

Keywords: Epidemiology; Intramedullary; Nigeria; Outcome; Spinal cord; Tumour.