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  • Updated 01.11.2024
  • Released 01.11.2024
  • Expires For CME 01.11.2027

Primary spinal cord tumors



Primary tumors of the spinal cord and its surrounding structures present a unique challenge to the clinical neurologist. Often presenting with nonspecific symptoms, such as back pain, weakness, and sensory disturbance, these tumors have unique cell line derivations, imaging appearances, behaviors, and prognoses. Spinal cord tumors are categorized by their locations, with primary spinal tumors occupying the intradural extramedullary and intramedullary compartments. Due to their sensitive locations, even tissue diagnosis presents a barrier to care. To date, the general approach to treatment of these tumors is surgical, often with application of intraoperative neuromonitoring. In some cases, new chemotherapeutic agents hold the promise of nonsurgical management. This article provides a broad overview of several of the most common intradural spinal cord tumors.

Key points

• Spinal cord tumors are classified by location within the spinal canal: extradural, intradural extramedullary, and intramedullary.

• Hereditary cancer predisposition syndromes, including neurofibromatosis type 1, neurofibromatosis type 2-related schwannomatosis, and Von Hippel-Lindau disease each predispose to certain primary spinal cord tumors.

• For most spinal cord tumors, the gold standard imaging is contrast-enhanced MRI.

• For many spinal cord tumors, the preferred treatment when possible is gross total resection.

• The use of intraoperative neuromonitoring, including somatosensory evoked potentials and motor evoked potentials is crucial during resection of these masses.

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