Spinal Cord Astrocytomas



Astrocytomas are the most common intramedullary tumors in children and occur secondary to ependymomas in adults. Astrocytomas in adults have better prognoses then their pediatric counterparts. For the purpose of this chapter, we concentrated mostly on low-grade astrocytomas in adults. Term “Low grade” Astrocytomas is usually reserved for WHO I and II tumors. The most common symptoms are pain, gait ataxia, motor weakness, sensory deficits, dysesthesias, and sphincter problems. Astrocytomas often take up contrast homogeneously on T1-weighted spinal MRI. On axial scans, astrocytomas are often eccentric and may transgress the pia mater to grow exophytically. The ideal goal of treatment should be radical gross total resection of tumor using microsurgical techniques with obligatory intraoperative neuromonitoring while preserving and improving normal neurological function. Surgical technique has been described in detail with accompanying video. The extent of surgical resection shows a significant association with survival and reduction of the risk of disease progression. Specific surgical aspects and complications have been discussed. The strongest predicting factor of functional outcome is the preoperative neurological condition. Median overall survival for low grade spinal astrocytomas was reported between 91 and 156 months (7.58–13 years) whereas pathologic grade is the strongest prognostic factor of overall survival and progression free survival. Recurrence, malignant transformation and role of adjuvant treatment have been discussed.


Spinal cord astrocytoma Low grade astrocytoma Pilocytic astrocytoma Surgical technique 

Supplementary material

Video 13.1.

Microsurgical resection of a spinal cord astrocytoma of the thoracic spine (MPG 521892 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity of MarburgMarburgGermany
  2. 2.Semmes MurpheyMemphisUSA
  3. 3.Department of NeurosurgeryUniversity of Tennessee Health Science CenterMemphisUSA

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