Intraspinal Tumors: analysis of 155 surgically treated cases in three hospitals, Addis Ababa, Ethiopia.
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Date
2020-11
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Addis Abeba University
Abstract
Background: intraspinal tumors are one of the rare tumors of the CNS. The occurrence and
distribution of intraspinal tumors by sex, age, and pathology are different among races
andregions. There is a paucity of information on operated cases of spinal tumors in patients in
sub-Saharan Africa
Objective: Theobjective of this study is to evaluate the demographics, histologic pattern,
anatomic distribution, and extent and outcome of surgery of Ethiopian patients with spinal
tumors.
Methodology: A retrospective study comprising a cohort of patients who underwent surgery for
spinal tumors in three teaching institutions in Addis Ababa, Ethiopia, from January 1,2015, to
June 30
th
, 2020. Data obtained included patient demographics, duration of symptoms, anatomic
location, imaging findings, McCormick scale before and after surgery, and type and outcome of
the surgery. The data was collected from the patient’s medical chart using a data collection
checklist and was encoded into IBM/SPSS version 25. Descriptive statistics and Binary and
multivariate Logistic Regression analysis was made to identify predictors of outcome. P<0.05
was considered significant
Result:A total of 155 patients were included. The mean age was 39.5 years. The mean duration
of illness was 13.9 months. 75.4% had lower limb weakness. Thoracic tumors predominate
46.9% followed by cervical tumors 20.6%. The majority of the tumors were IDEM 51.6%. GTR
was achieved in 67%. The most common histological origin was meningioma 35.9%. An overall
complication rate of 16.8% was observed, the commonest being new/worsening of neurologic
deficit occurred in 12.3%, a significant association was found in cervical tumors (p=0.048). The
operative mortality was 5.8%, cervical tumors (p=0.05), postoperative complications (neurologic
deficit (p=0.023), infection (p<0.001) and bedsore(P<0.001), and astrocytic tumors (p<0.001)were found to be independent risk factors for mortality. Although neurological improvement was
seen in 87%, patients with preoperative poor ambulatory status (p<0.001) and sensory deficit
(p=0.012) and discharged with worsened status (p<0.001)were found to be independent risk
factors for poor neurologic outcome.
Conclusion: Most of the patients improved in their clinical outcome, cervical tumors are prone to
postop complications and mortality. Patients who came with poor neurologic status and sensory
deficits will develop a poor neurologic outcome.
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Keywords
Intraspinal Tumors, surgical cases