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PRIMARY INTRASPINAL TUMOURS: THEIR CLINICAL PRESENTATION AND DIAGNOSISA. C. Da Roza 1
1 The Royal National Orthopaedic Hospital, London and Stanmore, England
1. An analysis has been made of the clinical features and investigations in ninety-five cases of primary intraspinal tumours. 2. Loss of muscle power was the commonest symptom, and was often ignored until late in the course of the disease. 3. Two-thirds of the patients had no pain in the spinal region, although five of these had either extensive growths or radiographical evidence of bone erosion by tumour. 4. One-third of the patients had urinary symptoms, and two of them had acute retention initially attributed to prostatic obstruction. 5. In eighteen cases posture and gait were abnormal. The case histories of five of these patients are recorded, and they emphasise the importance of recognising lumbar spasm and hamstring tightness in young patients as signs of a cauda equina neoplasm. 6. All patients had some detectable sensory, motor, or reflex changes, and these were mostly bilateral. 7. Radiography, and cerebrospinal fluid manometry and analysis, were helpful in establishing the diagnosis. 8. Hysteria should not be diagnosed until all efforts have been made to prove otherwise.
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