Philadelphia University + Thomas Jefferson University

Case Histories

Case 1

A healthy 27-year-old-woman, in her first pregnancy,developed moderate low back pain after a Caesarean section.  Despite bed rest and analgesics, the symptoms persisted and the pain began to radiate to her legs.  In extreme pain, she came to the emergency room.

MRI of the lumbar spine revealed an oblong mass at the lumbar spine (T12-L1 vertebrae).  The intradural mass was removed surgically, and later pathology classified it as a myxopapillary ependyoma.  

The patient made a full recovery; her only complaint was urinary retention, which was resolved once pain-killers were discontinued.  Post-operative MRI revealed no evidence of residual tumor.

Key Points

  • Worsening back pain and new neurologic complaints following spinal or epidural anaesthesia for Caesarean section or vaginal delivery can indicate an intraspinal tumor.
  • Most intradural spinal tumors present in the third to fifth decades of life.
  • Acute hemorrhage into a spinal cord tumor can cause symptoms ranging from severe low back pain to paralysis and loss of bladder or bowel control.

Case 2

A physically active 40-year-old man, father of four, developed intense, chronic pain that began in his lower back and traveled down his right leg.  The left leg was unaffected, and he assumed that his symptoms were due to sciatica. 

MRI of the lumbar spine revealed a large mass, possibly a schwannoma, at the lumbar spine (L5 vertebrae).  The mass took up 90% of the spinal canal. After three pre-op visits, during which the risks of surgery were discussed, the mass was removed surgically. 

In the patient's own words:

“I am someone who was never in the hospital my entire life...  I experienced no pain when I woke up after surgery.  I felt only non-painful pressure from the stitches.  Other than being tired I experienced no affects of sickness from any of the medication…. As of today I’m 100% better.  My walking, jumping and running are back to normal.  I feel no effects of the surgery”

The patient is being seen at regular intervals to check against the possibility of the tumor recurring. 

Key Points

  • The effects of a spinal tumor -- pain, numbness or paralysis -- do not have to be equal on the left and right sides of the body.
  • Pain from a spinal tumor can be easily misattributed to other causes, such as sciatica.


"All the pre-admission testing was performed with no problems.  There was a bit of a waiting time between each test but all were completed in one day.  The general physician who is affiliated through Dr. Sharan's Office was terrific.

"During the surgery everyone played their part and performed terrific.  All information was explained and all my questions were answered.  I was a bit anxious but relieved to know that the pain was going away.  The team and Dr. Sharan were excellent by having relaxing conversation and constant explanation of what was going to happen.

"Dr. Sharan is very friendly.  He was very attentive and concerned with all of my questions and symptoms."