Microsurgical treatment of intramedullary spinal cord tumours.
A series of 81 patients operated for intramedullary spinal cord tumours over a span of 12 years (1975-1986) is presented. The mean age of the patients was about 37 years and 9 patients were in the paediatric age (0-15 years). In 29 cases (36%) the tumours were located within the cervical region; in 34 cases the tumours were located in the thoracic region (42%) and in 18 cases the tumours were located within the medullary cone (22%). Ependymoma accounted for 52% of the cases (42 cases), astrocytoma for 20% (16 cases), lipoma for 7% (6 cases), hemangioblastoma for 6% (5 cases), metastatic tumours for 5% (4 cases); in the remaining 8 cases (10%) rare or very rare spinal tumours were found. The 9 patients in the paediatric age and 8 additional cases who had undergone previous surgery were then excluded from this review. In 59% of the patients with ependymoma and in 90% of the patients with astrocytoma severe neurological deficit were already present before the operation. Total tumour removal was accomplished in 81% of the cases with ependymoma, total or subtotal removal was achieved in 50% of the cases with astrocytoma. At long term follow-up study fair or good functional results were observed in 19 out of 41 cases of ependymoma (46%) and in 3 cases out of 10 of astrocytoma (30%). The surgical outcome was mostly related to the preoperative neurological conditions and to tumour malignancy grade.
Fornari
M
M
Department of Neurosurgery, Istituto Neurologico C. Besta, Milano, Italy.
Pluchino
F
F
Solero
C L
CL
Giombini
S
S
Luccarelli
G
G
Oliveri
G
G
Lasio
G
G
D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000601:surgery; D005260:Female; D006394:Hemangiosarcoma / Q000601:surgery; D006801:Humans; D008067:Lipoma / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata; D008866:Microsurgery; D008875:Middle Aged; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*