Intradural extramedullary lesions are tumors arising within the dura but outside the actual spinal cord and account for 40% of all spinal tumors. Among these, meningeomas (33%) and tumors of spinal nerves (27%) are the most common. Spinal meningeomas most frequently occur in the posterior or lateral thoracic region, followed by anterior cervical region and lumbosacral region. Clinical symptoms develop through an impairment of neural elements and pathways, producing both local and distal effects. Early diagnosis and adequacy of surgical intervention are the key determinants for the best long-term prognosis and preservation of neurological integrity. A complete and safe tumor removal and decompression of the spinal cord are the primary goals of surgery. Standard minimally-invasive posterior or posterolateral approaches provide an adequate exposure for a safe tumor removal in the majority of patients.
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