Dorsolumbar Junction Spinal Tumors at a Tertiary Care Center in Pakistan: Neurofibroma Predominance and Surgical Outcomes

Abstract

Objective: To estimate the prevalence and evaluate the surgical outcomes of dorsolumbar junction spinal tumors at a tertiary care center in Pakistan.

Methodology: This retrospective cohort study was conducted at Punjab Institute of Neurosciences, Lahore, including 35 patients operated for dorsolumbar junction (D11–L2) tumors between January 2021 and October 2024. Data extracted from records and PACS included demographics, presentation, imaging, operative details, histopathology, extent of resection, and outcomes. Tumors were classified by compartment and resection status, and primary outcomes were symptomatic improvement and complications. Data were analyzed descriptively using Microsoft Excel.

Results: The cohort comprised patients with a mean age of 36.25 ± 16.7 years, with male predominance (54.3%, n=19). Intradural extramedullary tumors were most prevalent (80.0%, n=28), with neurofibromas being the most common histological type (51.4%, n=18). Predominant presenting symptoms included backache radiating to lower limbs (80.0%, n=28) and neurological deficits. A posterior surgical approach was used in all patients achieving gross total resection(GTR) and near total resection (NTR) in 85.7% of patients. Immediate symptom relief was reported in 57.1% (n=20) of patients, with a tumor recurrence rate of 8.6% (n=3). Complications included new neurological deficits (5.7%, n=2) and cerebrospinal fluid leakage (5.7%, n=2).

Conclusion: This study highlights that dorsolumbar junction tumors in our Pakistani cohort were predominantly intradural-extramedullary, mainly neurofibromas and schwannomas, most often at D12–L1/L1–L2. Standard posterior approaches achieved effective resections with low complications and early symptomatic improvement. These findings demonstrate that with modern imaging and surgical expertise, centers in Pakistan can deliver care comparable to international standards, while larger multicenter studies are needed to validate and extend these results.