Spectrum of spinal cord space occupying lesions: An observational perspective from Pakistan.

Objective: To analyze the clinico-radiological characteristics and neurosurgical management of spinal space-occupying lesions (SOLs). Methodology: A retrospective observational study involving patients with spinal cord SOLs who underwent surgical management at the Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, between 2022 and 2024, was conducted after approval from the institute's review board. Patient profiles, clinical and radiological features, tumor location, and surgical outcomes were analyzed for comparative assessment. Results: With a mean age of 36.78 ± 16.57 years, a clear male preponderance of 62.5% (35) was noted for spinal SOLs in a Pakistani cohort of 56 patients. Among all spinal SOLs, 46.4% (26) were intradural intramedullary (IDIM) lesions, 25% (14) were intradural extramedullary (IDEM), and 28.6% (16) were extradural (ED) lesions. The most common symptoms were lower back pain in 65.4% (17) in IDIM, 68.8% (11) in ED, and 64.3% (9) in IDEM lesions. Post-operatively, Karnofsky Performance Scale (KPS) score was improved in all patients. The most common histopathology was meningioma in 76.9% (20) of IDIM patients, astrocytoma in 71.4%(10) of IDEM patients, and hemangioma in 62.5% (10) of ED patients. Conclusion: Patients with spinal lesions significantly improved clinically post-operatively, regardless of the anatomical location of the lesion. Surgical intervention remained the primary treatment for majority patients with spinal cord SOLs..