Contemporary management of adult intramedullary spinal tumors - Pathology and neurological outcomes related to surgical resection

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Abstract

Study Design: Retrospective chart review and review of the recent literature. Objectives: To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD). Setting: University of Miami/Jackson Memorial Medical Center Miami, FL, USA. Methods: We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005. Results: Histologic analysis revealed a predominance of ependymomas (50%) with astrocytomas only comprising 12.5% of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6% of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity. Conclusion: We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence.

Original languageEnglish
Pages (from-to)540-546
Number of pages7
JournalSpinal Cord
Volume46
Issue number8
DOIs
StatePublished - Aug 1 2008

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Pathology
Neoplasms
Morbidity
Ependymoma
Astrocytoma
Signs and Symptoms
Histology
Retrospective Studies

Keywords

  • Astrocytoma
  • Dorsal column dysfunction
  • Ependymoma
  • Intramedullary tumor

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

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title = "Contemporary management of adult intramedullary spinal tumors - Pathology and neurological outcomes related to surgical resection",
abstract = "Study Design: Retrospective chart review and review of the recent literature. Objectives: To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD). Setting: University of Miami/Jackson Memorial Medical Center Miami, FL, USA. Methods: We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005. Results: Histologic analysis revealed a predominance of ependymomas (50{\%}) with astrocytomas only comprising 12.5{\%} of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6{\%} of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity. Conclusion: We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence.",
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