Surgical treatment of intramedullary spinal cord tumors: prognosis and complications.

Surgical treatment of intramedullary spinal cord tumors: prognosis and complications. Research Abstract Details 

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Surgical treatment of intramedullary spinal cord tumors: prognosis and complications. Abstract Text:

M Nakamura,K Ishii,K Watanabe,T Tsuji,H Takaishi,M Matsumoto,Y Toyama,K Chiba,

Study design:Retrospective case series.Objective:To evaluate our recent treatment strategy for intramedullary spinal cord tumors.Setting:Department of Orthopaedic Surgery, Keio University, Japan.Methods:We reviewed 68 cases of intramedullary tumors (ependymoma, 33; astrocytoma, 23; hemangioblastoma, 12), treated surgically between 1994 and 2003. There were 42 males and 26 females whose mean age at the time of surgery was 43 years. The mean follow-up period was 6.2 years. The tumor malignancy grade according to the WHO classification was astrocytoma grade I, 3; grade II, 8 (low-grade: 11 cases); grade III, 10; grade IV, 2 (high-grade: 12 cases). All ependymomas were grade II. Three of the 12 hemangioblastomas were associated with von Hippel-Lindau disease.Results:Total excision was achieved in 90% of the ependymomas and functional improvement was obtained when the preoperative neurological deficit was mild. Approximately 50% of low-grade astrocytomas could be totally excised with favorable survival outcomes, suggesting that total excision should be attempted for low-grade astrocytomas. However, total excision of high-grade tumors was difficult and the functional outcomes were poor. Cordotomy should be considered in patients with a thoracic high-grade astrocytoma. Total resection was possible in 92% of hemangioblastoma, and the functional outcomes were good, however, more attention should be paid for tumors with feeding arteries on the ventral side and for those associated with von Hippel-Lindau disease.Conclusions:Predictors of good surgical outcome for intramedullary spinal cord tumors were histological grades of the tumors, surgical margins, and neurological status of the patient before surgery.Spinal Cord (2008) 46, 282-286; doi:10.1038/sj.sc.3102130; published online 2 October 2007.

Surgical treatment of intramedullary spinal cord tumors: prognosis and complications. Publishing Authors By Initials

M Nakamura,K Ishii,K Watanabe,T Tsuji,H Takaishi,M Matsumoto,Y Toyama,K Chiba,

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Surgical treatment of intramedullary spinal cord tumors: prognosis and complications. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Spinal cord : the official journal of the Internat

VOLUME: 46

Page Numbers: 282-6

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ISSN: 1362-4393

DAY: 2

MONTH: 10

YEAR: 2007

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LANGUAGE: eng

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AFFILIATION: 1Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.

Country: England

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MEDLINETA: Spinal Cord

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