Objective: Intradural spinal tumors present with back and extremity pain due to neuropatic pain and / or neurologic deficits. We aimed to compare the outcomes of the operated spinal intradural extramedullary and intramedullary tumors with or without using intraoperative neuromonitor (IONM).

Material and Methods: 82 patients, having undergone surgical excision of intradural spinal tumors, were included. Demographic datas, neuropatic pain VAS scores, neurologic deficits charted via Motor Muscle Strength Scale preoperatively and postoperatively, the anatomical location of tumors (extramedullary / intramedullary), histopathology, and use of intraoperative neurophysiologic monitoring were collected. Statistical significance was assessed by One-way ANOVA and post hoc Scheffe tests.

Results: 59 patients were operated for extramedullary tumor. The most common histologies were NSCT (schwannoma / neurofibroma), and menengioma. 23 patients were operated for intramedullary tumor. The commenest histopathologies were epandimoma and astrocytoma. Statistically significant postoperative neuropatic pain and neurologic defisit improvements were seen in extramedullary and intramedullary tumors except intramedullary astrocytomas. Using of IONM made a contribution by intramedullary tumors. However there was no significant difference determined for extramedullary tumors.

Conclusion: Grosstotal resection frequently can be applied in extramedullary tumors, it also should be aimed for intramedullary tumors. But if they are infiltrative, surgeons have to go for subtotal resection for achievement of neurologic detoriations. Postoperative improvements of neuropatic pains and neurologic deficits are high in extramedullary and intramedullary tumors, except intramedullary astrocytomas because of their invasive character. The effects of IONM on the results made a contribution on intramedullary astrocytomas. However there was no significant difference determined for extramedullary tumors.