Background: Primary extramedullary tumors involving multiple compartments around the spine are
a technically demanding group of tumors whose extent traverses beyond the normal confines
of those anatomical regions which fall in the common domain of neurosurgeons. In the
following series, we present 12 patients who were diagnosed with primary spinal extramedullary
tumors with multicompartmental extension, and whose surgical management was facilitated
by a combined multidisciplinary approach involving surgeons of other superspecialties.
This multidisciplinary assistance from the inception to the culmination of surgical
management helped in achieving a better surgical removal, thereby resulting in better
surgical outcomes. Materials and Methods: Twelve consecutive patients who fulfilled the inclusion criteria in the 5-year period
(January 2010 to January 2015) were included in the series based on the radiological
and pathological characteristics of the tumor. Depending on the site of the spine
involved by the lesion, radiologists and surgeons were involved from the planning
phase of the surgical management, and their assistance in procedures such as preoperative
embolization/ureteric stenting was sought whenever was deemed necessary. The extent
of resection and total blood loss was recorded meticulously. Regular follow-up (3,
6, and 12 months and 2 and 5 years) of the patients was done after the initial follow-up
at 6 weeks and their disability scores were recorded. Results: Of the 12 cases (6 males and 6 females), sacrum was the most common location of the
tumors (6). Histopathologically, giant-cell tumors, schwannomas, and chondrosarcomas
(3 each) were most common followed by Ewing's sarcoma (2) and malignant peripheral
nerve sheath tumor (1). Eight patients had functional status of McCormick scale 1
and two patients had a functional status of 2. One patient was lost to follow-up and
one patient died during surgery. Conclusion: Judicious involvement of access surgeons and adjunct therapies along with careful
preoperative planning can help in improving surgical outcome in multicompartmental
spinal tumors.
Key-words:
Access surgeon - adjunctive therapy - extramedullary spinal tumors - giant spinal
tumors - McCormick grade - multicompartmental - surgery
