Surgical treatment of intramedullary tumors (spinal cord and medulla oblongata). Analysis of 16 cases

1990 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Alireza Ahyai ◽  
Ulrich Woerner ◽  
Evangelos Markakis
2021 ◽  
Vol 27 (1) ◽  
pp. 11-20
Author(s):  
Eugene G. Pedachenko ◽  
Ievgenii I. Slynko ◽  
Oleksii S. Nekhlopochyn ◽  
Anna N. Nikiforova ◽  
Viacheslav S. Botev ◽  
...  

Objective. To determine the dynamics and state of neurosurgical care for tumors of the spinal cord and spine (TSCS) in Ukraine. Materials and methods. The work is based on the analysis of hospitalizations and surgical treatment of patients with TSCS in neurosurgical departments of Ukraine in 2000-2019. Results. In 2019, 1,325 patients with TSCS were hospitalized in neurosurgical departments of Ukraine, which is 2,3 times more than in 2000 (567), per 1 million population - almost 3 times (34,7 vs. 11, 6 ). Over 20 years, the number of operated patients increased 2,8 times (from 385 to 1079), per 1 million population - 3,6 times (from 7,9 to 28,3), there was an increase in surgical activity by 20% (from 67,9 to 81,4%), a decrease in the general and postoperative mortality - twice (from 2,6 to 1,2% and from 2,6 to 1,3% respectively). Patients with TSCS account for 1,5% of all patients hospitalized in neurosurgical departments of Ukraine, 12,8% of all CNS neoplasms and 5,2% of all spinal pathology. Vertebral tumors account for 42,64% of all TSCS and extramedullary tumors have an incidence rate similar to vertebral tumors (42,64%), intramedullary tumors account for 14,72%. In 2019, 74.4% more patients with extramedullary tumors were hospitalized than in 2000 (565 and 324 respectively), and 84.5% more were operated on (463 and 251 respectively). The rate of increase is even higher per 1 million population. In 2019, there were 14.8 hospitalizations per 1 million population for extramedullary tumors, which is 2.2 times greater than in 2000 (6,6 hospitalizations), and 12,1 operations, which is 2,4 times greater than in 2000 (5,1 operations). In 2019, patients with intramedullary tumors were hospitalized 2,2 times more than in 2000. (195 and 89 respectively), were operated 2,5 times more (151 and 61 respectively). The rate of increase is even 4higher per 1 million population. In 2019, there were 5,1 hospitalizations for intramedullary tumors per 1 million population, which is 2,8 times greater than in 2000 (1,8 hospitalizations), and 4,0 operations, which is 3,2 times greater than in 2000 (1,2 operations). In 2019, patients with vertebral tumors were hospitalized 3.7 times more than in 2000 (565 and 154 respectively), were operated 6,4 times more (465 and 73 respectively). The rate of increase is even higher per 1 million population. In 2019, there were 14,8 hospitalizations per 1 million population for vertebral tumors, which is 4,7 greater than in 2000 (3,1 hospitalizations), and 12,2 surgeries, which is 8,2 greater than in 2000 (1,5 operations). Сonclusions. The introduction of modern neuroimaging methods and advanced treatment methods into clinical practice has contributed to an increase in the number of hospitalizations and surgical interventions in TSCS.


2018 ◽  
Vol 73 (2) ◽  
pp. 88-95 ◽  
Author(s):  
V. A. Byvaltsev ◽  
I. A. Stepanov ◽  
E. G. Belykh ◽  
M. A. Aliyev

Background: Intradural spinal cord tumors include extramedullary and intramedullary tumors. The search for literature sources in the Pubmed, Medline, and E-Library databases detected a little number of researches on the long-term results of the surgical treatment of intradural spinal cord tumors. These clinical series include a small number of patients and do not consider the factors influencing clinical outcomes of surgical treatment.Aim: To evaluate the long-term results of surgical treatment in patients with intradural spinal cord tumors, to identify the main factors influencing the clinical and neurological outcomes of surgical interventions in this group of patients.Materials and methods: The study included 277 medical records of 244 patients with intradural extramedullary and 33 patients with intradural intramedullary tumors of the spinal cord. Clinical-neurological outcomes of surgical treatment in patients with intradural spinal cord tumors and factors influencing the outcomes were analyzed.Results: When comparing the degree of neurologic deficit in patients with intradural extramedullary tumors prior to surgery, no significant differences were found (p=0.241) both in the early postoperative period and 6 months after the surgery. Nevertheless, when comparing these indicators in a period of 12, 24, 36, 48, and 60 months after the surgery, statistically significant differences were revealed (p0.001). There was no statistically significant difference (p=0.437) between the scores in patients with intramedullary tumors on the modified McCormick Scale preoperatively, at the 6-month and one-year follow-up; however, comparison of the clinical and neurological indicators at 24, 26, 48, and 60 months revealed a significant difference (p0.001). The surgery outcomes in considered groups of patients were significantly influenced by the following indicators: the ASA risk level (odds ratio (OS) 2.138; 95% confidence interval (95% CI) 3.346–12.145) and intraoperative neurophysiological monitoring (OR 2.84; 95% CI 1.67–9.56).Conclusion: The study registered good and excellent long-term outcomes in most cases of intradural spinal cord tumors when the maximum possible tumor excision was performed. Analysis of the influence of various factors on the clinical and neurological outcomes in the study group of patients showed that the use of intraoperative neurophysiological monitoring and the degree of operational and anesthetic risk according to the ASA scale have a significant effect.


1991 ◽  
Vol 27 (5) ◽  
pp. 626
Author(s):  
Du Whan Choe ◽  
Hee Young Hwang ◽  
Hyeon Kyeong Lee ◽  
Moon Hee Han ◽  
In One Kim ◽  
...  

2021 ◽  
pp. 153857442110024
Author(s):  
Rozina Yasmin Choudhury ◽  
Kamran Basharat ◽  
Syeda Anum Zahra ◽  
Tien Tran ◽  
Lara Rimmer ◽  
...  

Over the decades, the Frozen Elephant Trunk (FET) technique has gained immense popularity allowing simplified treatment of complex aortic pathologies. FET is frequently used to treat aortic conditions involving the distal aortic arch and the proximal descending aorta in a single stage. Surgical preference has recently changed from FET procedures being performed at Zone 3 to Zone 2. There are several advantages of Zone 2 FET over Zone 3 FET including reduction in spinal cord injury, visceral ischemia, neurological and cardiovascular sequelae. In addition, Zone 2 FET is a technically less complicated procedure. Literature on the comparison between Zone 3 and Zone 2 FET is scarce and primarily observational and anecdotal. Therefore, further research is warranted in this paradigm to substantiate current surgical treatment options for complex aortic pathologies. In this review, we explore literature surrounding FET and the reasons for the shift in surgical preference from Zone 3 to Zone 2.


2003 ◽  
Vol 9 (2_suppl) ◽  
pp. 103-105
Author(s):  
P. Tabrizi ◽  
R.P. Spetzler

2006 ◽  
Vol 104 (3) ◽  
pp. 210-211 ◽  
Author(s):  
Farideh Nejat ◽  
Samira Zabihyan Cigarchi ◽  
Syed Shuja Kazmi

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