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Spine Surgery pp 573-582 | Cite as

Indications and Technique for Intradural Intramedullary Lesions

  • Maria WostrackEmail author
Chapter

Abstract

Intradural intramedullary neoplasms are extremely rare. Only 5–10% of all spinal and 2–4% of all CNS tumors are located intramedullary. Prospective data and thus clear evidence for optimal treatment are missing. The chapter will describe the key essentials of the perioperative diagnostics, surgical aspects and outcome demonstrated by cases of the both most common intramedullary entities.

References

  1. 1.
    Bostrom A, Kanther NC, Grote A, Bostrom J. Management and outcome in adult intramedullary spinal cord tumours: a 20-year single institution experience. BMC Res Notes. 2014;7:908.CrossRefGoogle Scholar
  2. 2.
    Slooff JL, Kernohan JW, MacCarty CS. Primary intramedullary tumors of the spinal cord and filum terminale. Philadelphia-London: WB Saunders Company; 1964. p. 124–9.Google Scholar
  3. 3.
    Yang S, Yang X, Hong G. Surgical treatment of one hundred seventy-four intramedullary spinal cord tumors. Spine. 2009;34:2705–10.CrossRefGoogle Scholar
  4. 4.
    Parsa AT, Lee J, Parney IF, Weinstein P, McCormick PC, Ames C. Spinal cord and intradural-extraparenchymal spinal tumors: current best care practices and strategies. J Neuro-Oncol. 2004;69:291–318.CrossRefGoogle Scholar
  5. 5.
    McCormick PC, Stein BM. Intramedullary tumors in adults. Neurosurg Clin N Am. 1990;1:609–30.CrossRefGoogle Scholar
  6. 6.
    Babu R, Karikari IO, Owens TR, Bagley CA. Spinal cord astrocytomas: a modern 20-year experience at a single institution. Spine. 2014;39:533–40.CrossRefGoogle Scholar
  7. 7.
    Duong LM, McCarthy BJ, McLendon RE, Dolecek TA, Kruchko C, Douglas LL, Ajani UA. Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004–2007. Cancer. 2012;118:4220–7.CrossRefGoogle Scholar
  8. 8.
    Manzano G, Green BA, Vanni S, Levi AD. Contemporary management of adult intramedullary spinal tumors-pathology and neurological outcomes related to surgical resection. Spinal Cord. 2008;46:540–6.CrossRefGoogle Scholar
  9. 9.
    Bostrom A, von Lehe M, Hartmann W, Pietsch T, Feuss M, Bostrom JP, Schramm J, Simon M. Surgery for spinal cord ependymomas: outcome and prognostic factors. Neurosurgery. 2011;68:302–8; discussion 309.CrossRefGoogle Scholar
  10. 10.
    Brotchi J, Fischer G. Spinal cord ependymomas. Neurosurg Focus. 1998;4:e2.CrossRefGoogle Scholar
  11. 11.
    Minehan KJ, Shaw EG, Scheithauer BW, Davis DL, Onofrio BM. Spinal cord astrocytoma: pathological and treatment considerations. J Neurosurg. 1995;83:590–5.CrossRefGoogle Scholar
  12. 12.
    Tarapore PE, Modera P, Naujokas A, Oh MC, Amin B, Tihan T, Parsa AT, Ames CP, Chou D, Mummaneni PV, Weinstein PR. Pathology of spinal ependymomas: an institutional experience over 25 years in 134 patients. Neurosurgery. 2013;73:247–55. discussion 255CrossRefGoogle Scholar
  13. 13.
    Fakhreddine MH, Mahajan A, Penas-Prado M, Weinberg J, McCutcheon IE, Puduvalli V, Brown PD. Treatment, prognostic factors, and outcomes in spinal cord astrocytomas. Neuro-Oncology. 2013;15:406–12.CrossRefGoogle Scholar
  14. 14.
    Garces-Ambrossi GL, McGirt MJ, Mehta VA, Sciubba DM, Witham TF, Bydon A, Wolinksy JP, Jallo GI, Gokaslan ZL. Factors associated with progression-free survival and long-term neurological outcome after resection of intramedullary spinal cord tumors: analysis of 101 consecutive cases. J Neurosurg Spine. 2009;11:591–9.CrossRefGoogle Scholar
  15. 15.
    Adams H, Avendano J, Raza SM, Gokaslan ZL, Jallo GI, Quinones-Hinojosa A. Prognostic factors and survival in primary malignant astrocytomas of the spinal cord: a population-based analysis from 1973 to 2007. Spine. 2012;37:E727–35.CrossRefGoogle Scholar
  16. 16.
    Chang UK, Choe WJ, Chung SK, Chung CK, Kim HJ. Surgical outcome and prognostic factors of spinal intramedullary ependymomas in adults. J Neuro-Oncol. 2002;57:133–9.CrossRefGoogle Scholar
  17. 17.
    Lee SH, Chung CK, Kim CH, Yoon SH, Hyun SJ, Kim KJ, Kim ES, Eoh W, Kim HJ. Long-term outcomes of surgical resection with or without adjuvant radiation therapy for treatment of spinal ependymoma: a retrospective multicenter study by the Korea Spinal Oncology Research Group. Neuro-Oncology. 2013;15:921–9.CrossRefGoogle Scholar
  18. 18.
    Pencovich N, Bot G, Lidar Z, Korn A, Wostrack M, Meyer B, Bydon M, Jallo G, Constantini S. Spinal ependymoma with regional metastasis at presentation. Acta Neurochir. 2014;156:1215–22.CrossRefGoogle Scholar
  19. 19.
    Ahmed R, Menezes AH, Awe OO, Mahaney KB, Torner JC, Weinstein SL. Long-term incidence and risk factors for development of spinal deformity following resection of pediatric intramedullary spinal cord tumors. J Neurosurg Pediatr. 2014;13:613–21.CrossRefGoogle Scholar
  20. 20.
    McGirt MJ, Chaichana KL, Atiba A, Bydon A, Witham TF, Yao KC, Jallo GI. Incidence of spinal deformity after resection of intramedullary spinal cord tumors in children who underwent laminectomy compared with laminoplasty. J Neurosurg Pediatr. 2008;1:57–62.CrossRefGoogle Scholar
  21. 21.
    Yao KC, McGirt MJ, Chaichana KL, Constantini S, Jallo GI. Risk factors for progressive spinal deformity following resection of intramedullary spinal cord tumors in children: an analysis of 161 consecutive cases. J Neurosurg. 2007;107:463–8.PubMedGoogle Scholar
  22. 22.
    McGirt MJ, Garces-Ambrossi GL, Parker SL, Sciubba DM, Bydon A, Wolinksy JP, Gokaslan ZL, Jallo G, Witham TF. Short-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 238 patients. Neurosurgery. 2010;66:1005–12.CrossRefGoogle Scholar
  23. 23.
    Forster MT, Marquardt G, Seifert V, Szelenyi A. Spinal cord tumor surgery–importance of continuous intraoperative neurophysiological monitoring after tumor resection. Spine. 2012;37:E1001–8.CrossRefGoogle Scholar
  24. 24.
    Sala F, Bricolo A, Faccioli F, Lanteri P, Gerosa M. Surgery for intramedullary spinal cord tumors: the role of intraoperative (neurophysiological) monitoring. Eur Spine J. 2007;16(Suppl 2):S130–9.CrossRefGoogle Scholar
  25. 25.
    Costa P, Peretta P, Faccani G. Relevance of intraoperative D wave in spine and spinal cord surgeries. Eur Spine J. 2013;22:840–8.CrossRefGoogle Scholar
  26. 26.
    Oh MC, Kim JM, Kaur G, Safaee M, Sun MZ, Singh A, Aranda D, Molinaro AM, Parsa AT. Prognosis by tumor location in adults with spinal ependymomas. J Neurosurg Spine. 2013;18:226–35.CrossRefGoogle Scholar
  27. 27.
    Oh MC, Tarapore PE, Kim JM, Sun MZ, Safaee M, Kaur G, Aranda DM, Parsa AT. Spinal ependymomas: benefits of extent of resection for different histological grades. J Clin Neurosci. 2013;20:1390–7.CrossRefGoogle Scholar
  28. 28.
    Lin Y, Smith ZA, Wong AP, Melkonian S, Harris DA, Lam S. Predictors of survival in patients with spinal ependymoma. Neurol Res. 2015;37:650–5.CrossRefGoogle Scholar
  29. 29.
    Oh MC, Ivan ME, Sun MZ, Kaur G, Safaee M, Kim JM, Sayegh ET, Aranda D, Parsa AT. Adjuvant radiotherapy delays recurrence following subtotal resection of spinal cord ependymomas. Neuro-Oncology. 2013;15:208–15.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryKlinikum rechts der Isar, Technische Universität MünchenMunichGermany

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