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58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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Functional outcome after surgical removal of intramedullary spinal cord tumors. Analysis of 104 patients

Funktionelle Ergebnisse nach operativer Resektion intramedullärer Tumoren des Rückenmarks. Eine Analyse von 104 behandelten Patienten

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  • corresponding author I.E. Sandalcioglu - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Essen
  • B. El-Hamalawi - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Essen
  • T. Gasser - Neurochirurgische Klinik und Poliklinik, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • S. Asgari - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Essen
  • D. Stolke - Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Essen

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.04.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc235.shtml

Published: April 11, 2007

© 2007 Sandalcioglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: This study was undertaken to evaluate factors with impact on functional results of surgically treated intramedullary spinal cord tumors (IMSCT) and to determine the reasons for operative morbidity.

Methods: Between January 1990 and August 2006 a consecutive series of 104 patients with IMSCT were referred to our institution and underwent surgical treatment. There were 61 males (59%) and 43 (41%) females. Mean age was 43.3 years. Functional outcome was analyzed depending on histological features, age, tumor localization and the number of involved spinal segments. The mean follow-up period was 34.4 months. Operative removal of the IMSCT was performed under standard microsurgical conditions with intraoperative monitoring of somatosensory evoked potentials (SSEP).

Results: The most frequent IMSCTs were neuroepithelial tumors in 57 patients (54.8%) including 43 patients with ependymomas, 17 astrocytomas, and 2 lesions without further histological classification. Non-neuroepithelial tumors included 16 metastases, 9 cavernomas, 11 hemangioblastomas, 2 dermoid cysts, one enterogenetic cyst, one lipoma, one PNET and one gangliglioma. Complete tumor removal was achieved in 82 cases (79%) and subtotal resection in 18 cases. In 4 cases only a biopsy was performed. The overall postoperative neurological state was improved or unchanged in 69 patients (66%) and worse in 35 patients (34%).

Conclusions: The strongest predicting factor of functional outcome was the preoperative neurological condition following the histological differentiation of the IMSCT. Although there was no outcome difference with respect to the age and tumor extension, thoracically located IMSCTs proved to harbor an increased risk of postoperative surgical morbidity.