Spinal tumor

• Predicting the risk of lymph node metastasis in colon cancer: development and validation of an online dynamic nomogram based on multiple preoperative data
• Phase 2 Trial of Stereotactic Body Radiation Therapy with Dose Escalation Using Simultaneous Integrated Boost for Spinal Metastases
• Primary Carcinoid Tumor of the Central Nervous System: A Rare Case Report with a Diagnostic Challenge
• Effects and Mechanisms of Paeoniflorin in Relieving Neuropathic Pain: Network Pharmacological Analysis and Experimental Validation
• Impact of preoperative nutritional status on morbidity and mortality in elderly patients undergoing spine surgery for metastatic spinal tumors: a role for the Geriatric Nutritional Risk Index
• Rare case of schwannomatosis presenting with cauda equina syndrome: a case report
• The Mechanism of HDAC2 Inhibitors on Chronic Pancreatitis Pain
• Epitheloid Osteoblastoma of C2 Vertebra as an Unusual Cause of Developmental Torticollis: A Case Report

Spinal tumor epidemiology.

Spinal tumor classification.

Spinal tumor clinical features

Spinal tumor diagnosis.

The recommendations were developed by members of the Development Recommendations Group representing seven stakeholder scientific societies and organizations of specialists involved in various forms of care for patients with spinal tumours in Poland. The recommendations are based on data yielded from systematic reviews of the literature identified through electronic database searches. The strength of the recommendations was graded according to the North American Spine Society's grades of recommendation for summaries or reviews of studies.

Results: The recommendation group developed 89 level A-C recommendations and a supplementary list of institutions able to manage primary malignant spinal tumours, namely, spinal sarcomas, at the expert level. This list, further called an appendix, helps clinicians who encounter spinal tumours refer patients with suspected spinal sarcoma or chordoma for pathological diagnosis, surgery and radiosurgery. The list constitutes a basis of the network of expertise for the management of primary malignant spinal tumours and should be understood as a communication network of specialists involved in the care of primary spinal malignancies.

Conclusion: The developed recommendations together with the national network of expertise should optimize the management of patients with spinal tumours, especially rare malignancies, and optimize their referral and allocation within the Polish national health service system ¹⁾.

see Spinal tumor treatment.

The patient is a 58-year-old male, who is a former smoker and has a history of extrinsic asthma. He presented with chronic low back pain and was diagnosed with an intradural lesion at the L3-L4 level. The patient did not exhibit any neurological focal deficits.

Diagnosis:

The diagnostic impression is an intradural lesion at the L3-L4 level. The leading differential diagnoses include a possible ependymoma, while metastasis is considered less likely. The surgical intervention has been recommended to obtain a pathological diagnosis, guide further treatment, and provide symptomatic relief.

Procedure:

The patient will be positioned in the prone decubitus on the surgical table. Radiological marking of the L3 and L4 levels will be performed to avoid confusion due to sacralization of L5. The surgical procedure will involve midline exposure and skeletonization of the spinous processes at the L3 and L4 levels. A laminectomy will be carried out using a piezoelectric tool, along with flavectomy, and exposure of the spinal canal. The dura will be opened along the midline, and cerebrospinal fluid (CSF) will be collected using a syringe for cytological analysis. Microsurgical resection of the intradural lesion, which appears to be related to the filum, will be performed. Primary dural closure will be accomplished, and the laminas will be repositioned using miniplates and screws. The closure will follow the standard technique.

Equipment Required:

For this surgical procedure, the following equipment will be necessary:

X-ray machine

Microscope

Piezoelectric motor

Requests for intraoperative pathology examination, definitive pathology, and CSF cytology will be prepared.

Expected Complications to Avoid:

The primary complications to be vigilant against include:

Incorrect level entry

Laminotomy extension

CSF leakage

Lumbosacral root injury

Hematoma in the surgical bed

Infection

Postoperative Follow-up:

As part of the postoperative care plan, a lumbar MRI will be requested to assess the surgical outcome and ensure the patient's recovery is progressing as expected.