gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Functional outcome for spinal intradural tumors – a ten years experience

Meeting Abstract

  • Karl-Michael Schebesch - Klinik und Poliklinik für Neurochirurgie am Universitätsklinikum Regensburg
  • Stefan Müller - Klinik und Poliklinik für Neurochirurgie am Universitätsklinikum Regensburg
  • Alexander Brawanski - Klinik und Poliklinik für Neurochirurgie am Universitätsklinikum Regensburg
  • Martin Proescholdt - Klinik und Poliklinik für Neurochirurgie am Universitätsklinikum Regensburg

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.09.02

doi: 10.3205/14dgnc315, urn:nbn:de:0183-14dgnc3151

Published: May 13, 2014

© 2014 Schebesch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Intradural spinal tumors (ISM) account for approx. 4% of CNS tumors in adults. Despite establishment of intraoperative neuromonitoring (IOM) in neurosurgical ORs, operative treatment is associated with up to 30–60% transient or permanent neurological deterioration. Here we present our operative experience during ten years in a large population. We focused on the correlation between extent of resection (EOR), recurrence rate and recovery of functional outcome.

Method: 71 patients with complete datasets were included in this retrospective analysis. The observational period was 2003–2013. The charts, pre- and postoperative imaging (MRI, CT) and the follow-up outpatient documentation were screened for EOR, style of resection (piece meal versus en bloc), procedural-related complications. These findings were correlated to histology, rate of recurrence and functional outcome according to Karnofsky Score (KS), McCormick Score (MCS) and Medical Research Council Neurological Performance Score (MRC-NPS) in uni- and multivariate analysis.

Results: Complete resection was achieved in 57 patients (80.3%), significantly associated with meningeal and ependymal histology (p<0.05). Most frequent histology was ependymoma (36.6%), meningeoma (11.3%) and astrocytoma (9.8%). The recurrence rate was 11.3%. Factors influencing the recurrence rate were age, astrocytic histology, grading and EOR. The KS remained stable during the observational period but the neurological performance significantly improved in 37.5%. Pain and sensory deficits showed the best results of improvement (>60%) while the lowest improvement rates were found for motor deficit and bladder dysfunction.

Conclusions: Microsurgical resection significantly improved the neurological performance in the long-term. Pain and sensory deficits recovered better than motor and vegetative disturbances. EOR, age, histology and grading significantly influenced the recurrence rate.