Surgical Management and Outcomes of Intradural Spinal Metastases

Abstract

square BACKGROUND: Intradural spinal metastases are rare but clinically significant manifestations of systemic malignancies. Their management remains controversial, and evidence guiding surgical outcomes is limited. The aim of recent study is to evaluate the clinical features, surgical outcomes, and prognostic factors with intradural spinal metastases treated surgically at a single center. square METHODS: A retrospective review of 14 patients who underwent surgical resection for intradural extra-or intramedullary spinal metastases between 2014 and 2025 was conducted. Neurological outcomes were assessed using the McCormick scale. Overall survival and postoperative survival were analyzed using Kaplan-Meier and Cox regression models. square RESULTS: Lung cancer was the predominant primary tumor (80%), with thoracic spine being the most involved site (64.3%). Gross total resection (GTR) was achieved in 71.4% of the cases. Neurological function improved in 28.6% of the cases, remained stable in 42.9%, and worsened in the 28.6% postoperatively. Median postoperative survival was 9.5 months, and overall survival from primary diagnosis was 31.8 months. Subtotal resection and intramedullary involvement were associated with worse outcomes, though not statistically significant. square CONCLUSIONS: Surgical resection of intradural spinal metastases can offer meaningful neurological improvement and symptom relief in selected patients. GTR is associated with better outcomes, and careful preoperative selection is critical. Multidisciplinary approaches remain essential for optimizing patient care.