Incidence, histopathology, and surgical outcome of tumors of spinal cord, nerve roots, meninges, and vertebral column-Data based on single institutional (Sher-i-Kashmir Institute of Medical Sciences) experience

TLDR

Spinal tumors lack community‑based studies in the Kashmir Valley, and data are limited to a single regional neurosurgical center. The study aimed to establish a hospital‑based regional epidemiology of spinal tumors in the Valley. A retrospective analysis of 531 malignant and nonmalignant spinal tumors managed at the center from 1983 to 2014 under a uniform medical protocol was performed. The analysis revealed a low hospital‑based incidence of 0.24/100,000 per year, with 32.6 % malignant and 67.4 % benign tumors; metastatic lesions and extradural‑intradural tumors rose to 16.4 %, mortality was 3.2 %, recurrence 4.9 %, and benign tumors had better surgical outcomes than malignant ones.

Abstract

In the absence of a community-based study on the spinal tumors in the Valley, medical records of the only Regional Neurosurgical Center are available.The aim of this study is to establish a hospital-based regional epidemiology of spinal tumors in the Valley since the data are derived from a single institution.A retrospective analysis of 531 malignant and nonmalignant tumors of spinal cord, its coverings and vertebrae, which were managed in a Regional Neurosurgical Center under a standard and uniform medical-protocol over 30-year period from 1983 to 2014.The hospital-based incidence for all spinal tumors was 0.24/100,000 persons per year. The malignant spinal cord and vertebral tumors comprised 32.58% (173/531) of all tumors, and benign spinal cord and vertebral tumors comprised 67.42% (358/531). The extradural-intradural tumors such as metastatic lesions and primary malignant vertebral tumors were on rise with 16.38% (87/531) cases. The children below 18 years were 5.46% (29/531), of which 55.17% (16/29) were below 9 years. The most common primary bone malignancy was multiple myeloma (54.54% =12/22). Histopathologically, the most common metastatic deposit in the spinal canal was non-Hodgkin's lymphoma (24.61% =16/65). A mortality of 3.20% (17/531) was noted. Recurrences were noted in 4.90% (26/531), and adjuvant therapies were given to 16.38% (87/531) patients.The malignant spinal cord and vertebral tumors, especially metastatic deposits, are on rise in elderly population. The surgical outcome, in terms of recovery and spinal stability, of benign tumors, is comparatively better than malignant ones. The study reveals a low regional incidence (hospital-based) of spinal tumors.