Introduction
Methods
Grading of MSCC
Statistics
Results
Etiology
Condition
|
NM-SCC
|
M-SCC
|
---|---|---|
No of cases | 13 | 44 |
Males, n (%) | 6 (46.1) | 20 (45.4) |
Age at diagnosis of SCC, months, median (IQR; range) | 95 (23–125; 4–179) | 52 (20.5–112; 0–205) |
Etiology, n (%) |
Extradural11 (84.5)
|
Extradural 28 (63.6)
|
Lipoma 6 (46.1) | Neuroblastoma 12 (27.2) | |
Aneurysmal bone cyst 4 (30.7) | Ewing Sarcoma 7 (15.9) | |
Osteoblastoma 1 (7.7) | Yolk SacTumor 2 (4.5) | |
Intradural extramedullary 2 (15.4)
| Metastatic tumors 7 (15.9) | |
Meningioma 1 (7.7) | - Ewing Sarcoma (chest wall) | |
Plexiform Neurofibromas 1 (7.7) | - Ewing Sarcoma (pelvis) | |
- Ewing Sarcoma (spine) | ||
- Hepatoblastoma | ||
- Osteosarcoma (distalfemur) | ||
- Rhabdomyosarcoma (thigh) | ||
- Rhabdoid Tumor (kidney) | ||
Intradural extramedullary 7 (15.9)
| ||
Malignant Schwannoma 1 (2.3) | ||
AT-RT 1 (2.3) | ||
Metastatic tumors 5 (11.3) | ||
- AT-RT | ||
- Choroid Plexus Carcinoma | ||
- Medulloblastoma (2) | ||
- Suprasellar Germ Cell Tumor | ||
Intramedullary 9 (20.4)
| ||
Ependymoma 2 (4.5) | ||
Pylocitic Astrocytoma 3 (6.8) | ||
High-Grade Glioma 1 (2.3) | ||
Low-Grade Glioma 3 (6.8) |
Clinical presentation
Feature/characteristic
|
At diagnosis
| |
---|---|---|
N
|
%
| |
No of cases
| 44 | 100 |
Timing of SCC
| ||
At diagnosis | 33 | 75.0 |
At relapse | 11 | 25.0 |
Symptom–diagnosis interval, days
| ||
≤ 7 | 19 | 43.2 |
8–30 | 11 | 25 |
> 30 | 14 | 31.8 |
Symptoms
| ||
Motor deficit | 44 | 100 |
Grade 1 | 10 | 22.7 |
Grade 2 | 19 | 43.2 |
Grade 3 | 15 | 34.1 |
Pain | 26 | 59.1 |
Upper extremities | 3 | 11.5 |
Lower extremities | 12 | 46.1 |
Spinal | 11 | 42.3 |
Irritability | 3 | 6.8 |
Sphincter dysfunction | 19 | 43.2 |
Respiratory distress | 2 | 4.5 |
Spinalcord MRI, N (%) | 44 | 100 |
Level of spinal cord compression
| ||
Cervical | 3 | 6.8 |
Cervico-thoracic | 3 | 6.8 |
Thoracic | 16 | 36.4 |
Thoraco-lumbar | 8 | 18.2 |
Lumbar | 5 | 11.4 |
Lumbar-sacral | 7 | 15.9 |
Thoracic-lumbar-sacral | 1 | 2.3 |
Neurosurgical treatment | 42 | 95.4 |
Neurosurgical treatment
Feature/characteristic
|
E-I/E
|
I
|
p
|
---|---|---|---|
No of cases, N (%) | 33 (75) | 9 (20.4) | |
Age at diagnosis of SCC,months, median (IQR; range) | 63 (21–129; 0–205) | 48 (25–106; 10–198) | ns |
Pre-operative spinalcord MRI, N (%) | 33 (100) | 9 (100) | ns |
NS recovery, days, median (IQR; range) | 6 (3–9.3; 2–41) | 18 (14–20; 10–32) | 0.00112 |
ICU recovery, hours, median (IQR; range) | 17 (0–24; 0–984) | 24 (0–24; 0–50) | ns |
Interval NS admission-surgery, days, median (IQR; range) | 0.5 (0–1; 0–29) | 7 (3–9; 0–18) | 0.00228 |
Post-operative spinal cord MRI, N (%)* | 33 (100) | 9 (100) | ns |
NS perioperative deaths, N (%) | 0 (0) | 0 | ns |
NS perioperative complications, N (%) | 4 (12.1) | 0 | ns |
-Increased motor deficit | 1 (3.0) | ||
-Spinal stenosis | 1 (3.0) | ||
-Bilateral lower-limb oedema | 1 (3.0) | ||
-Seizures | 1 (3.0) | ||
NS resection, N (%) | ns | ||
-biopsy | 4 (12.1) | 0 (0) | |
-partial | 26 (78.8) | 7 (77.8) | |
-complete | 3 (9.1) | 2 (22.2) |
Motor deficit at neurosurgery discharge in E-I/E-SCC
No change
|
Improvement
|
Normal
| ||||
---|---|---|---|---|---|---|
N
|
%
|
N
|
%
|
N
|
%
| |
Grade of Motor Deficit
| ||||||
Grade 1 (n = 7) | 0 | 0 | 4 | 57.1 | 3 | 42.8 |
Grade 2 (n = 14) | 3 | 21.4 | 10 | 71.4 | 1 | 7.1 |
Grade 3 (n = 12) | 7 | 58.3 | 4 | 33.3 | 1 | 8.3 |
Five-year survival
ID
|
Sex
|
Level of SCC
|
Type
|
Age at SCC (months)
|
Interval symptoms -SCC diagnosis (days)
|
Motor deficit (grade)
|
Diagnosis
|
NCH
|
Status
|
Follow-up (months)
|
---|---|---|---|---|---|---|---|---|---|---|
1 | F | L1-L3 | E | 101 | 7 | 2 | Metastasis of Rhabdomyosarcoma | Yes | Dead | - |
2 | F | D5-D6 | E | 108 | 4 | 1 | Ewing Sarcoma | Yes | Alive | 61 |
3 | M | D9-D11 | E | 195 | 2 | 2 | Metastasis of Ewing Sarcoma | Yes | Alive | 4 |
4 | M | C2-D4 | I | 25 | 30 | 2 | PylociticAstrocytoma | Yes | Alive | 92 |
5 | M | L1-L3 | E | 46 | 4 | 2 | Neuroblastoma | Yes | Alive | 8 |
6 | M | D12-L4 | E | 3 | 2 | 3 | Neuroblastoma | Yes | Alive | 98 |
7 | F | D4-D11 | I/E | 63 | 120 | 1 | Metastasis of Medulloblastoma | Yes | Alive | 86 |
8 | F | D9-L1 | I/E | 36 | 7 | 2 | Metastasis of AT-RT | Yes | Dead | - |
9 | M | C4-D5 | E | 13 | 7 | 2 | Neuroblastoma | Yes | Dead | 104 |
10 | F | D6-D10 | I | 102 | 14 | 3 | Anaplastic Ependymoma | Yes | Alive | 90 |
11 | F | L5-S1 | I/E | 165 | 60 | 1 | Malignant Schwannoma | Yes | Alive | 13 |
12 | F | L1-S1 | E | 24 | 12 | 3 | Neuroblastoma | Yes | Alive | 77 |
13 | M | D10-D12 | E | 163 | 60 | 3 | Metastasis of Ewing Sarcoma | Yes | Alive | 65 |
14 | F | D10-D11 | E | 87 | 60 | 3 | Ewing Sarcoma | Yes | Dead | - |
15 | F | D11-L1 | E | 10 | 7 | 1 | Neuroblastoma | Yes | Alive | 106 |
16 | F | D7-D9 | E | 39 | 10 | 1 | Neuroblastoma | Yes | LF | - |
17 | M | L5-S2 | E | 204 | 30 | 1 | Ewing Sarcoma | Yes | Alive | 24 |
18 | F | D1-D5 | E | 21 | 7 | 3 | Ewing Sarcoma | Yes | Dead | - |
19 | F | L4-S1 | E | 171 | 7 | 2 | Metastasis of Osteosarcoma | Yes | LF | - |
20 | M | C2-C6 | I | 106 | 360 | 3 | Low Grade Glioma | Yes | Alive | 126 |
21 | M | D11-S5 | E | 20 | 60 | 3 | Malignant Germ Cell Tumor | Yes | Alive | 82 |
22 | F | D1-D3 | I | 42 | 30 | 2 | Low Grade Glioma | Yes | Alive | 28 |
23 | F | D5-D11 | I | 10 | 90 | 3 | PylociticAstrocytoma | Yes | Alive | 104 |
24 | F | D10 | I/E | 129 | 20 | 3 | Metastasis of Malignant Suprasellar Germ Cell Tumor | Yes | Dead | - |
25 | M | C2-D2 | I | 48 | 60 | 2 | PylociticAstrocytoma | Yes | Alive | 114 |
26 | F | D4-D10 | E | 41 | 60 | 1 | Neuroblastoma | Yes | LF | - |
27 | F | D12-L2 | E | 134 | 7 | 2 | Ewing Sarcoma | Yes | Alive | 60 |
28 | M | D8 | I/E | 36 | 2 | 2 | Metastasis of Medulloblastoma | Yes | Dead | - |
29 | M | L2-S1 | I/E | 52 | 10 | 1 | AT-RT | Yes | Dead | - |
30 | M | D2-D3 | E | 116 | 360 | 1 | Ewing Sarcoma | Yes | Alive | 2 |
31 | F | L2-L4 | I | 107 | 240 | 1 | Ependymoma | Yes | Alive | 39 |
32 | M | L2-L4 | E | 2 | 0 | 3 | Metastasis of renal RT | Yes | Dead | - |
33 | M | D11-L3 | E | 0 | 0 | 3 | Neuroblastoma | Yes | Alive | 23 |
34 | F | D8-L5 | I/E | 79 | 7 | 2 | Metastasis of Choroid Plexus Carcinoma | Yes | Dead | - |
35 | M | D11-L3 | E | 8 | 2 | 3 | Neuroblastoma | Yes | Alive | 46 |
36 | F | L2-S2 | E | 19 | 60 | 3 | Neuroblastoma | None | Alive | 60 |
37 | M | L3-S1 | I/E | 147 | 15 | 2 | Neuroblastoma | Yes | Dead | - |
38 | M | D2-D4 | E | 205 | 7 | 2 | Metastasis of Ewing Sarcoma | Yes | Dead | - |
39 | M | C5 | E | 90 | 3 | 2 | Metastasis of Hepatoblastoma | Yes | Dead | - |
40 | F | L5 | I | 198 | 30 | 2 | High Grade Glioma | Yes | Alive | 2 |
41 | F | D10-L2 | I | 18 | 180 | 2 | Ganglioglioma | Yes | Alive | 94 |
42 | F | D7-D9, L3 | E | 14 | 60 | 2 | Malignant Germ Cell Tumor (Yolk Sac) | None | Alive | 104 |
43 | M | D2-D6 | E | 11 | 9 | 3 | Neuroblastoma | Yes | Alive | 91 |
44 | F | C6 | E | 101 | 7 | 2 | Ewing Sarcoma | Yes | Alive | 42 |