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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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Surgical outcome and prognostic factors in patients with intramedullary spinal cord tumors

Operative Therapie und prognostische Faktoren bei Patienten mit intramedullären spinalen Tumoren

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  • corresponding author J.A. Seidel - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg
  • G Antoniadis - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg
  • H.-P. Richter - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg
  • M. Engelhardt - Neurochirurgische Klinik der Universität Ulm am BKH Günzburg

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.04.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc236.shtml

Published: April 11, 2007

© 2007 Seidel 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: The aim of this retrospective study is to analyze different factors affecting functional outcome for patients with surgically treated intramedullary low grade tumors including the preoperative neurological condition, histological grading, age and location.

Methods: In a retrospective study 28 patients with intramedullary low grade tumors (21 ependymomas, 6 astrocytomas and 1 subependymoma) were evaluated. They had been surgically treated at our department between 1994 and 2004. The location of the tumors was cervical in 7 cases, cervicothoracic in 4 cases, thoracic in 10 cases, and conus in 7 cases. The follow-up period varied from 4 to 130 months (mean: 56.7 months).

Results: Complete tumor removal could be achieved in 26 cases (92.9%) and subtotal resection in 2 cases. Pre- and postoperative functional performance was classified according to the McCormick scale in grade I-IV. Neurological evaluation revealed functional improvement from initial preoperative clinical status in 12 patients, no significant change in 13 patients, and deterioration in only 3 patients. 15 of 17 patients without or with slight preoperative deficits (McCormick scale grade I) remained unchanged or improved after the operation. They have a better postoperative prognosis than those with severe preoperative neurological disturbances (grade III/IV). We could show an outcome difference with respect to the age and the location. All 7 patients with tumor location in the conus showed a postoperative improvement. There was no outcome difference with respect to the histological grading. Recurrences were observed in two patients with astrocytomas, in one patient with astrocytoma II and in one patient with ependymoma II.

Conclusions: Surgical removal of intramedullary low grade tumors is beneficial to patients. In addition to age and location, the most determining factor of functional outcome was the preoperative neurological condition. We would therefore recommend early surgery to achieve good functional outcome.