Spinal Cord Tumours: Intramedullary and Extramedullary

Spinal cord tumours are masses that develop within the spinal canal and compress the spinal cord or nerve roots. With early diagnosis and appropriate surgery, excellent results are achieved in most patients.^1,2

Classification

Intramedullary Tumours (Inside the Spinal Cord)

These are tumours originating from the spinal cord itself. The most common ones are:

• Ependymoma: The most common intramedullary tumour in adults.³ Usually well-circumscribed, total removal is possible.
• Astrocytoma: More common in children.^4,5 Total removal can be difficult due to its diffuse growth pattern.
• Haemangioblastoma: May be associated with Von Hippel-Lindau disease. Vascular in structure, well-circumscribed.

Extramedullary-Intradural Tumours (Inside the Dura, Outside the Spinal Cord)

These are tumours originating from the spinal meninges or nerve roots:

• Meningioma: Most common in the thoracic region. Cure is possible with total removal.
• Schwannoma/Neurofibroma: Originates from the nerve sheath. Usually causes unilateral root compression.

Extradural Tumours (Outside the Dura)

Metastatic tumours are the most common in this group.

Symptoms

They vary depending on the localisation: weakness in the arm in the neck region, a band-like sensation around the trunk and spasticity in the legs in the chest region, weakness in the legs and bladder problems in the lower back region. Pain is the most common first symptom — night pain and pain that increases at rest should raise suspicion of a tumour.

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