Turkish Neurosurgery 2006 , Vol 16 , Num 3
Primary Intradural Conus and Cauda Equina Tumors: Long-time Outcome With 14 Years Follow- up
Kadir KOTİL, Turgay BİLGE
Department of Neurosurgery, Haseki Educational and Research Hospital, Istanbul, Turkey OBJECTIVE: This clinical study evaluated mixed tumor pathologies in the lumbar dural sac. Currently, there are few published clinical studies with longterm follow-up in the literature.

METHODS: This is a retrospective review of the clinical presentation, diagnosis and management of 24 patients with primary intradural conus and cauda equina tumors (ICCET). We operated on 24 ICCET patients during the last 14 years.

RESULTS: The largest pathology group of 9 (37.4%) cases was ependymomas. The rest were 5 (20.8%) neurinomas, 4 (16.6%) meningiomas, 1 (4.16%) epidermoid (with dermal sinus tract), 4 (16.6%) dermoids (one case with adult tethering cord and dermal sinus tract) and 1(4.16 %) hemangioblastoma. Two of the cases (ependymoma and neuironoma) had giant tumors, which extended from L1 to L5. Low back pain and urinary symptoms were the most common initial symptoms of the cases. The diagnosis was made with standart myelography (2 cases), computed tomographic myelography (4 cases) and magnetic resonance imaging (18 cases). All patients underwent tumor resection through a single posterior approach. The neurological conditions of 22 (91%) patients improved. Two patients did not improve and the postoperative Nurick Grade was grade 5. Postoperative radiotherapy was used in one case with malignant neurinoma. There was a rest tumor in one patient who had a dermoid tumor (4.6 %). The mean follow-up period was 75.5 months.

CONCLUSION: We report the effect of surgical treatment for ICCET as excellent in nineteen out of 24 cases. ICCET are generally slow-growing, bening lesions. They are mostly surgically curable and radiotherapy is not usually necessary. The prognosis after surgical treatment depends not only on histology but also on the degree of neurological deficit before the surgery, and the importance of early diagnosis and subsequent treatment is well recognized. Keywords : conus, cauda equina, intradural, primary, tumor

Corresponding author : Kadir Kotil, kadirkotil@superonline.com