Tohoku J. Exp. Med., 2006, 209(1)

Clinical Features of Cauda Equina Tumors Requiring Surgical Treatment

YOICHI SHIMADA, NAOHISA MIYAKOSHI,¹ YUJI KASUKAWA,¹ MICHIO HONGO,¹ SHIGERU ANDO¹ and EIJI ITOI¹

Rehabilitation Division, Akita University Hospital, Akita, Japan, and ¹Department of Orthopedic Surgery, Akita University School of Medicine, Akita, Japan

In this study, we evaluated the clinical features of cauda equina tumors requiring surgical treatment. Medical records of 28 patients with cauda equina tumors (13 men and 15 women) undergoing surgical treatment were retrospectively reviewed. The majority of histological diagnoses indicated schwannoma (23 cases, 82%), and the remaining 5 indicated ependymoma, neurofibroma, meningioma, and ganglioneuroblastoma. In 86% of the cases, the initial symptom was pain in the lower back and/or lower extremities. Preoperatively, half of the patients had symmetrical pain in the lower back or lower extremities, severe pain in the supine position, or pain that was increased by coughing. One third of the patients needed morphine to control nocturnal pain. Tumor size, as determined by magnetic resonance imaging (MRI), correlated with preoperative symptom duration (r = 0.66, p < 0.001). These findings indicate that symmetrical lower back pain and/or pain that radiates to both lower extremities and increases in the supine position are characteristic of cauda equina tumors. The correlation between symptom duration and tumor size indicates that earlier diagnosis of this tumor is necessary. Earlier diagnosis based on these characteristic symptoms should make use of further examinations such as MRI.

keywords —— cauda equina tumors; clinical features; surgical treatment

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 209, 1-6

Correspondence: Yoichi Shimada, M.D., Rehabilitation Division, Akita University Hospital, 1-1-1 Hondo, Akita 010-8543, Japan.

e-mail: yshimada@med.akita-u.ac.jp