Tommy Alfandy Nazwar, Farhad Bal’afif, Donny Wisnu Wardhana, Christin Panjaitan
Introduction: Intradural extramedullary (IDEM) spinal tumors represent a crucial focus in neurosurgery due to their potential to pose significant diagnostic and therapeutic challenges. Consequently, their management necessitates careful planning. This study reports and analyzes a series of cases involving IDEM tumors of the spinal cord, specifically cystic schwannoma and meningioma. Case presentation: Case 1: A 28-year-old man presented with intermittent pain radiating to the left thigh without associated numbness. Magnetic resonance imaging (MRI) revealed a complex cystic lesion within the spinal canal at the level of the inferior end plate of L4 to the mid-body of S1, associated with cystic schwannoma. The lesion was completely excised through a surgical procedure, resulting in the complete resolution of the patient’s symptoms. Case 2: A 51-year-old woman complained of difficulty walking over the past 2 months and persistent tingling sensations in both legs. MRI imaging indicated the presence of a solid intradural extramedullary mass associated with spinal meningioma at the T6-T7 level. The lesion was entirely removed through a surgical procedure, leading to an improvement of motor strength in both legs. Conclusion: Spinal IDEM tumors such as cystic schwannoma and meningioma, especially when associated with thoracolumbar spondylosis, pose significant diagnostic and therapeutic challenges. MRI plays a pivotal role in lesion characterization and surgical planning. Successful management requires individualized surgical strategies, such as total laminectomy, laminectomy with arthrodesis, or limited unilateral laminectomy, accompanied by meticulous intraoperative and postoperative care to minimize complications. © 2025 by Acta Medica Saliniana.
Department of Surgery, Faculty of Medicine, Universitas Brawijaya/ Dr. Saiful Anwar General Hospital, Jalan Jaksa Agung No. 2, Klojen, East Java, Malang, 65112, Indonesia
