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Features and outcome of surgical management of spinal tumors in a cohort of nigerian patients
OBJECTIVE: There is a dearth of information on operated cases of spinal tumors in patients in sub-Saharan Africa. The objective of this study was to evaluate the histologic pattern, anatomic distribution, and the extent and outcome of surgery in Nigerian patients with spinal tumors. METHODS: This r...
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2015
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| Summary: | OBJECTIVE: There is a dearth of information on operated cases of spinal tumors in patients in sub-Saharan Africa. The objective of this study was to evaluate the histologic pattern, anatomic distribution, and the extent and outcome of surgery in Nigerian patients with spinal tumors. METHODS: This retrospective study comprised a cohort of Nigerians who underwent surgery for spinal tumors. Data obtained included patient demographics, duration of symptoms, anatomic location, imaging findings, Frankel grading before and after surgery, and the type and outcome of surgery. Univariate analysis was performed, and the results were compared with findings from other parts of the world. RESULTS: There were 59 patients (male-to-female ratio 1:1.1) with a bimodal age distribution. The highest incidence (20.34%) was observed in the 20–29 age group. More than half of the patients (58.06%) presented with symptoms lasting at least 6 months, and in 35.48% the duration exceeded 12 months. Motor deficit was present in 97.73% of patients at presentation. Functional grading at presentation was Frankel A in 38.10% of patients, Frankel C in 26.19%, Frankel B in 16.67%, Frankel D in 16.67%, and Frankel E in 2.38%. The tumors were predominantly located in the thoracic region (65.45%), and 58% were extradural in location. Gross total tumor excision was performed in 50.88% of cases, while subtotal resection was performed in 24.56%. Spinal stabilization was carried out in 17.86% of patients, with spinous process wiring and vertical strut being the most common method of stabilization (80%) among this group. Metastasis was the most common histologic tumor type (23.21%). Meningioma accounted for 12.50% of tumors, while ependymoma, astrocytoma, and hemangioma each accounted for 7.14%. The most common source of metastasis was the prostate (38.46%). Postoperatively, 45% of patients improved neurologically, 52.5% remained the same, and 2.5% deteriorated. There was no perioperative mortality. CONCLUSIONS: Metastasis was the most common histologic type of spinal tumor in this study, and the most frequent location was extradural. The surgical outcome was satisfactory in most cases, with neurologic function remaining stable or improving after surgery in the majority of patients. |
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