title: Surgical treatment of primary spinal tumors in the conus medullaris.
abstract: OBJECTIVE
  The objective of this study was to evaluate the characteristics and surgical outcome of the conus medullaris tumors.
  
  
  METHODS
  We retrospectively reviewed 26 patients who underwent surgery for conus medullaris tumor from August 1986 to July 2007. We analyzed clinical manifestation, preoperative MRI findings, extent of surgical resection, histopathologic type, adjuvant therapy, and outcomes.
  
  
  RESULTS
  There were ependymoma (13), hemangioblastoma (3), lipoma (3), astrocytoma (3), primitive neuroectodermal tumor (PNET) (2), mature teratoma (1), and capillary hemangioma (1) on histopathologic type. Leg pain was the most common symptom and was seen in 80.8% of patients. Pain or sensory change in the saddle area was seen in 50% of patients and 2 patients had severe pain in the perineum and genitalia. Gross total or complete tumor resection was obtained in 80.8% of patients. On surgical outcome, modified JOA score worsened in 26.9% of patients, improved in 34.6%, and remained stable in 38.5%. The mean VAS score was improved from 5.4 to 1.8 among 21 patients who had lower back pain and leg pain.
  
  
  CONCLUSIONS
  The surgical outcome of conus medullaris tumor mainly depends on preoperative neurological condition and pathological type. The surgical treatment of conus medullaris tumor needs understanding the anatomical and functional characteristics of conus meudllaris tumor for better outcome.
authors.affiliation: Department of Neurosurgery, The Spine and Spinal Cord Institute, Yonsei University, College of Medicine, Seoul, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Han
authors.forename: Sung-Uk
authors.initials: SU
authors.lastname: Kuh
authors.forename: Dong-Kyu
authors.initials: DK
authors.lastname: Chin
authors.forename: Keun-Su
authors.initials: KS
authors.lastname: Kim
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Jin
authors.forename: Yong-Eun
authors.initials: YE
authors.lastname: Cho