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Journal of Neuro-Oncology

, Volume 142, Issue 2, pp 347–354 | Cite as

Intramedullary spinal cord metastases: an institutional review of survival and outcomes

  • Anshit Goyal
  • Yagiz Yolcu
  • Panagiotis Kerezoudis
  • Mohammed Ali Alvi
  • William E. Krauss
  • Mohamad BydonEmail author
Clinical Study

Abstract

Introduction

Intramedullary spinal cord metastases (ISCMs) are rare lesions affecting the spinal cord in patients with disseminated malignancy. Today, due to increased survival, these lesions are more frequently diagnosed. Literature on survival and neurologic outcomes is sparse. Herein, we describe a single institutional case series on ISCMs reported to date in the English literature.

Methods

We retrospectively analyzed the medical records of patients diagnosed with intramedullary metastatic lesions at our institution between 1997 and 2016. We analyzed different approaches to management and factors influencing survival and neurologic outcomes.

Results

A total of 70 patients (86 lesions) were analyzed. Most lesions were found in thoracic spinal cord (50%) followed by cervical (34%) and conus medullaris (14%). Mean age at diagnosis was 55.6 ± 10.6 years with 60% (n = 42) being females. Median survival was 104.5 days (range 1–888 days). Twenty-three patients (33%) received conservative management, 39 (56%) received palliative radiotherapy, whereas 8 (11%) underwent surgery with one patient receiving only a biopsy. Age, sex, presence of concomitant brain and other systemic metastasis didn’t influence survival. Patients with solitary metastases had longer survival compared to multiple lesions (3.6 vs. 2.2 months, p = 0.01). In patients with solitary lesions without brain metastasis, surgical resection was associated with significantly longer survival (6 months vs. 3 months, p = 0.02).

Conclusion

The overall survival in patients with intramedullary metastasis remains poor. Surgical management may contribute to improved survival and neurologic outcomes in selected patients. Intramedullary metastasis may have a greater role on overall survival compared to systemic metastatic burden.

Keywords

Metastases Intramedullary Spinal cord neoplasms Spine Spinal cord Conservative treatment Outcomes Survival 

Abbreviations

ISCM

Intramedullary spinal cord metastases

SD

Standard deviation

MMCS

Modified McCormick Score

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic SurgeryMayo ClinicRochesterUSA
  2. 2.Department of Neurologic SurgeryMayo ClinicRochesterUSA

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