Surgical treatment of intramedullary spinal cord tumors: Prognosis and complications

Masaya Nakamura, K. Ishii, Koota Watanabe, T. Tsuji, H. Takaishi, Morio Matsumoto, Y. Toyama, K. Chiba

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)282-286
Number of pages5
JournalSpinal Cord
Volume46
Issue number4
DOIs
Publication statusPublished - 2008 Apr 11

Fingerprint

Spinal Cord Neoplasms
Astrocytoma
Hemangioblastoma
Ependymoma
von Hippel-Lindau Disease
Neoplasms
Therapeutics
Cordotomy
Orthopedics
Japan
Thorax
Retrospective Studies
Arteries
Survival

Keywords

  • Intramedullary spinal cord tumor
  • Prognosis
  • Surgical outcome

ASJC Scopus subject areas

  • Clinical Neurology

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Surgical treatment of intramedullary spinal cord tumors : Prognosis and complications. / Nakamura, Masaya; Ishii, K.; Watanabe, Koota; Tsuji, T.; Takaishi, H.; Matsumoto, Morio; Toyama, Y.; Chiba, K.

In: Spinal Cord, Vol. 46, No. 4, 11.04.2008, p. 282-286.

Research output: Contribution to journalArticle

Nakamura, Masaya ; Ishii, K. ; Watanabe, Koota ; Tsuji, T. ; Takaishi, H. ; Matsumoto, Morio ; Toyama, Y. ; Chiba, K. / Surgical treatment of intramedullary spinal cord tumors : Prognosis and complications. In: Spinal Cord. 2008 ; Vol. 46, No. 4. pp. 282-286.
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