[Radical surgical tactics in the treatment of patients with intramedullary neoplasms inducing severe neurological deficit. What can we find in this?].
BACKGROUND
Radical surgery for intramedullary spinal cord tumors (IMSCT) is currently accepted as a first-line treatment. At the same time most papers concerning this problem show that surgical results depend on the preoperative neurological status of a patient. Many authors consider that the functional status of a patient with severe neurological deficit does not change for the better.


METHODS
In 2002-2006, at the Academician N. N. Burdenko Research Institute of Neurosurgery, the author operated on 63 patients diagnosed as having IMSCT as evidenced by magnetic resonance imaging (MRI). Among them, there were 29 patients with severe preoperative neurological deficit (3-4 scores by the McCormick scale (MCS)). Thirteen (45%) tumors were totally removed; in the remaining patients with diffuse tumors, tumor removal was subtotal (more than 80% of a tumor being removed, as confirmed by MRI scans). There were neither neurological status deteriorations, nor fatal outcomes. Nineteen patients were found to have functional improvement by 1-3 MCS scores. Out of them, 15 (52%) patients became completely independent in their everyday activities due to surgery.


CONCLUSIONS
In this series of patients with IMSCT and severe preoperative neurological deficit, tumor removal led to functional improvement in the patient and his independence in everyday life in 52% of cases. Radical surgery for localized IMSCT does not deteriorate the patients' functional status.
Kushel'
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IuV
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010291:Paresis / Q000209:etiology*; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*