Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 101. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | 1002 Section Tumors and Inflammation Figure 2. Differential diagnosis A differential diagnosis is mandatory because various diseases can mimicka primary spinal tumor. a T2W sagittal image shows a tumorous lesion at the conus level. Frozen section biopsy revealed a sarcoidosis and further surgery was stopped subsequent to the biopsy. b Preoperative T2W image and c postoperative MRI of another case with a conus lesion being a metastasis of a malignant melanoma. non-Hodgkin s lymphoma hypertrophic neuropathies . Dejerine-Sottas disease Charcot-Marie-Tooth disease 31 Myxopapillary ependymomas exclusively occur in the conus and filum terminale Symptoms precede diagnosis by years Intradural-Intramedullary Tumors Ependymomas Spinal ependymomas are usually well circumscribed Case Introduction arising from ependymal cells lining the central canal or its remnants and from the cells of the ventriculus terminalis in the filum terminale. Myxopapillary ependymomas occur exclusively in the conus medullaris and filum terminale. Hemorrhage and cystic degeneration are common. Ependymomas account for 60 of glial spinal cord tumors and comprise 90 of primary tumors in the filum terminale and cauda equina 30 31 . Mean age is 43 years with a slight female predominance. For myxopapillary ependymomas of the cauda equina region the mean age is 28 years with a slight male predominance. Intramedullary tumors are mainly benign tumors found in children or young adults. Complaints of back pain or neck pain are found in 65 of patients with intramedullary ependymomas. Previous history is usually often long because these tumors are slow growing and there are often mild objective neurological deficits. The average reported duration between the onset of such symptomatology and diagnosis has been reported to be around years 2 3 14 27 31 . Intradural Tumors Chapter 35 1003 Low back pain or sacral pain leg weakness and sphincter dysfunction are the complaints and signs found in patients with .
