Intradural Extramedullary Tumors

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Nerve sheath tumors (Fig. 29.1) usually arise from the dorsal roots. They are relatively avas-cular, globoid and without calcification. The dorsal root of origin is most often intimately adherent to the tumor and can rarely be preserved during surgical resection. In patients with neurofibromatosis, these tumors are multiple and occur at numerous levels of the spinal canal. When located in the area of the intervertebral foramen, they may assume a characteristic dumbbell configuration, with an extra- and an intradural component (Fig. 29.1).

Meningiomas [11] (Fig. 29.2), unlike nerve sheath tumors, arise from arachnoid cluster cells and thus are usually separate from the nerve roots. These tumors tend to have a lateral or ventrolateral location relative to the spinal cord. They may arise in any age group, mostly occurring between the fifth and seventh decades of life, and are seen more frequently in women. They are most often located in the thoracic spine.

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