Contemporary management of adult intramedullary spinal tumors-pathology and neurological outcomes related to surgical resection.
METHODS
Retrospective chart review and review of the recent literature.


OBJECTIVE
To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD).


METHODS
University of Miami/Jackson Memorial Medical Center Miami, FL, USA.


METHODS
We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005.


RESULTS
Histologic analysis revealed a predominance of ependymomas (50%) with astrocytomas only comprising 12.5% of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6% of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity.


CONCLUSIONS
We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence.
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
G
G
Manzano
B A
BA
Green
S
S
Vanni
A D
AD
Levi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004806:Ependymoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009460:Neurologic Examination; D009493:Neurosurgery / Q000379:methods*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome