Spinal cord tumors of the thoracolumbar junction requiring surgery: A retrospective review of clinical features and surgical outcome

DongAh Shin, Sang Hyun Kim, Keung Nyun Kim, Hyun Cheol Shin, Do Heum Yoon

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose: A retrospective review of medical records and imaging studies. To investigate characteristic clinical features and surgical outcomes of spinal cord tumors (SCTs) of the thoracolumbar junction (TLJ). The spinal cord transitions to the cauda equina in the TLJ. The TLJ contains the upper and lower motor neurons of the spinal cord and cauda equina. As a result, the clinical features of lesions in the TLJ vary, and these anatomical characteristics may affect surgical outcome. Materials and Methods: Pathological diagnosis, clinical features, neurological signs, and surgical outcomes were investigated in 76 patients surgically treated at our institute for SCTs arising from T11 to L2. The patients were divided into epiconus (T11-12, n=18) and conus groups (L1-2, n=58). Results: Patients in the epiconus group had hyperactive deep tendon reflexes (DTRs), while those in the conus group had hypoactive DTRs (p<0.05). Nine patients were misdiagnosed with intervertebral disc diseases (IVDs) before correct diagnoses were made. It was impossible to definitively determine the exact cause of symptoms in four patients who had both SCTs and IVDs. Conclusion: Among SCTs of the TLJ, the epiconus group displayed upper motor neuron syndrome and the conus group displayed lower motor neuron syndrome. SCTs of the TLJ were frequently misdiagnosed as IVDs due to symptomatic similarities. SCTs of the TLJ should be included in differential diagnosis of back and leg pain, and it is highly recommended that routine lumbar magnetic resonance imaging include the TLJ.

Original languageEnglish
Pages (from-to)988-993
Number of pages6
JournalYonsei Medical Journal
Volume48
Issue number6
DOIs
Publication statusPublished - 2007 Dec 1

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Spinal Cord Neoplasms
Motor Neurons
Cauda Equina
Stretch Reflex
Diagnostic Errors
Spinal Cord
Diagnostic Imaging
Back Pain
Medical Records
Leg
Differential Diagnosis
Magnetic Resonance Imaging
Intervertebral disc disease

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Shin, DongAh ; Kim, Sang Hyun ; Kim, Keung Nyun ; Shin, Hyun Cheol ; Yoon, Do Heum. / Spinal cord tumors of the thoracolumbar junction requiring surgery : A retrospective review of clinical features and surgical outcome. In: Yonsei Medical Journal. 2007 ; Vol. 48, No. 6. pp. 988-993.
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abstract = "Purpose: A retrospective review of medical records and imaging studies. To investigate characteristic clinical features and surgical outcomes of spinal cord tumors (SCTs) of the thoracolumbar junction (TLJ). The spinal cord transitions to the cauda equina in the TLJ. The TLJ contains the upper and lower motor neurons of the spinal cord and cauda equina. As a result, the clinical features of lesions in the TLJ vary, and these anatomical characteristics may affect surgical outcome. Materials and Methods: Pathological diagnosis, clinical features, neurological signs, and surgical outcomes were investigated in 76 patients surgically treated at our institute for SCTs arising from T11 to L2. The patients were divided into epiconus (T11-12, n=18) and conus groups (L1-2, n=58). Results: Patients in the epiconus group had hyperactive deep tendon reflexes (DTRs), while those in the conus group had hypoactive DTRs (p<0.05). Nine patients were misdiagnosed with intervertebral disc diseases (IVDs) before correct diagnoses were made. It was impossible to definitively determine the exact cause of symptoms in four patients who had both SCTs and IVDs. Conclusion: Among SCTs of the TLJ, the epiconus group displayed upper motor neuron syndrome and the conus group displayed lower motor neuron syndrome. SCTs of the TLJ were frequently misdiagnosed as IVDs due to symptomatic similarities. SCTs of the TLJ should be included in differential diagnosis of back and leg pain, and it is highly recommended that routine lumbar magnetic resonance imaging include the TLJ.",
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Spinal cord tumors of the thoracolumbar junction requiring surgery : A retrospective review of clinical features and surgical outcome. / Shin, DongAh; Kim, Sang Hyun; Kim, Keung Nyun; Shin, Hyun Cheol; Yoon, Do Heum.

In: Yonsei Medical Journal, Vol. 48, No. 6, 01.12.2007, p. 988-993.

Research output: Contribution to journalReview article

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N2 - Purpose: A retrospective review of medical records and imaging studies. To investigate characteristic clinical features and surgical outcomes of spinal cord tumors (SCTs) of the thoracolumbar junction (TLJ). The spinal cord transitions to the cauda equina in the TLJ. The TLJ contains the upper and lower motor neurons of the spinal cord and cauda equina. As a result, the clinical features of lesions in the TLJ vary, and these anatomical characteristics may affect surgical outcome. Materials and Methods: Pathological diagnosis, clinical features, neurological signs, and surgical outcomes were investigated in 76 patients surgically treated at our institute for SCTs arising from T11 to L2. The patients were divided into epiconus (T11-12, n=18) and conus groups (L1-2, n=58). Results: Patients in the epiconus group had hyperactive deep tendon reflexes (DTRs), while those in the conus group had hypoactive DTRs (p<0.05). Nine patients were misdiagnosed with intervertebral disc diseases (IVDs) before correct diagnoses were made. It was impossible to definitively determine the exact cause of symptoms in four patients who had both SCTs and IVDs. Conclusion: Among SCTs of the TLJ, the epiconus group displayed upper motor neuron syndrome and the conus group displayed lower motor neuron syndrome. SCTs of the TLJ were frequently misdiagnosed as IVDs due to symptomatic similarities. SCTs of the TLJ should be included in differential diagnosis of back and leg pain, and it is highly recommended that routine lumbar magnetic resonance imaging include the TLJ.

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