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Intradural, Intramedullary Tumor

  • Mari L. GrovesEmail author
  • George Jallo
Chapter

Abstract

Intramedullary spinal cord tumors (IMSCTs) are rare lesions and represent 2–4% of all central nervous system neoplasms. Primary glial tumors, ependymomas, and astrocytomas, as well as hemangioblastomas, represent well over 90% of IMSCTs. For these low-grade lesions, an attempt at gross total resection has been shown to impact progression-free survival as well as overall survival. Intraoperative neuromonitoring has emerged as an important adjunct for surgical resection and can help guide the extent of resection by providing real-time feedback that impacts the extent of resection. Gross total resection can be safely achieved in cases where there is an identifiable plane between the tumor and normal spinal cord. Higher grade lesions often do not have clear planes, and there is limited utility in aggressive surgical resection. Functional outcomes are determined by the patient’s preoperative status as most patients will maintain their preoperative function, with only a few showing some improvement. Technological advances have pushed surgical techniques for IMSCT resection and have improved our ability to more aggressively treat these lesions.

Keywords

Intramedullary Spinal cord tumors Ependymoma Astrocytoma Intraoperative neuromonitoring Laminoplasty Surgical technique 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Johns Hopkins HospitalDepartment of NeurosurgeryBaltimoreUSA
  2. 2.Johns Hopkins All Children’s HospitalDepartment of NeurosurgerySt. PetersburgUSA

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