The Correlation Between Recordable MEPs and Motor Function During Spinal Surgery for Resection of Thoracic Spinal Cord Tumor

✓ The development of a transplantable model brain tumor in the neonatal dog, the adaptation of the tumor to tissue culture, and the successful growth of the tumor in adult mongrel dogs has been adapted to producing similar tumors in the thoracic spinal cord of the adult dog. Ten adult dogs, weighing 4 to 25.4 kg each, were subjected to formal laminectomy. The tumor cell suspension was injected by hand with a Hamilton syringe at two or three sites over a distance of 1 cm; each site received an injection volume to 0.02 to 0.05 cc of the cell suspension after the dura had been opened. Immediately after injection the field was copiously irrigated and the puncture area sealed with a single drop of ethyl cyanoacrylate. Tumor cells for injection were obtained by thawing ampules stored at −195°C in a mixture of 10% dimethyl sulfoxide and RPMI 1640 culture medium. Cells were resuspended in Hank's balanced salt solution and 15% fetal calf serum on ice. Solutions had 90% cell viability, and animals received a dose in the range of 3 to 13 × 106 cells. Eight animals developed tumors and became paraparetic on the 9th to 14th postinjection day. Metrizamide myelography in three animals revealed complete blocks; two animals underwent spinal computerized tomography (CT) and demonstrated syringohydromyelia. Histology revealed the tumors to be highly vascular primitive neoplasms that invaded the surrounding cord. This spinal cord tumor model is large enough to be operated on, studied by CT and myelography, and subjected to pharmacological, electrophysiological, and blood flow study.

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Inexplicable Abdominal Pain due to Thoracic Spinal Cord Tumor

Annals of Rehabilitation Medicine ◽

10.5535/arm.2014.38.2.273 ◽

2014 ◽

Vol 38 (2) ◽

pp. 273 ◽

Cited By ~ 1

Author(s):

Jung Eun Park ◽

Myung Eun Chung ◽

Dae Heon Song ◽

Hyun Sook Choi

Keyword(s):

Spinal Cord ◽

Abdominal Pain ◽

Spinal Cord Tumor ◽

Thoracic Spinal Cord ◽

Thoracic Spinal

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Intrathecal morphine analgesia after cervical and thoracic spinal cord tumor surgery

Journal of Neurosurgery Spine ◽

10.3171/2014.8.spine1436 ◽

2014 ◽

Vol 21 (6) ◽

pp. 899-904 ◽

Cited By ~ 4

Author(s):

Beate Poblete ◽

Christoph Konrad ◽

Karl F. Kothbauer

Keyword(s):

Spinal Cord ◽

Intensive Care ◽

Rating Scale ◽

Intrathecal Morphine ◽

Spinal Cord Tumor ◽

Tumor Resection ◽

Numeric Rating Scale ◽

Thoracic Spinal Cord ◽

Dural Closure ◽

Thoracic Spinal

Object The aim of this study was to provide evidence for the effect of intrathecal morphine application after spinal cord tumor resection. Methods Twenty patients participated in a prospective open proof-of-concept study. During dural closure, morphine (7 μg/kg) was injected into the subarachnoid space. All patients were monitored in an intensive care setting postoperatively. Pain, additional opioids given, and vital parameters were recorded. Results Six patients received a mean morphine dose of 365 μg between C-3 and C-7 and 14 patients received a mean dose of 436 μg between T-2 and T-12. In the cervical and thoracic groups, the mean Numeric Rating Scale score was highest upon intensive care unit admission (1.2 and 2.5, respectively) and declined at 12 hours (0.5 and 0.8, respectively). Minimal extra morphine was required. Minor side effects occurred without consequence. Conclusions Intrathecal morphine for postoperative analgesia after resection of cervical and thoracic spinal cord tumors is effective and safe. These preliminary results require confirmation by larger comparative studies and further clinical experience.

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Operative Treatment of Anterior Thoracic Spinal Cord Herniation: Three New Cases and an Individual Patient Data Meta-analysis of 126 Case Reports

Operative Neurosurgery ◽

10.1227/01.neu.0000327686.99072.e7 ◽

2009 ◽

Vol 64 (suppl_1) ◽

pp. ONS145-ONS160 ◽

Cited By ~ 12

Author(s):

Rob J.M. Groen ◽

Berrie Middel ◽

Jan F. Meilof ◽

J.B. Margot de Vos-van de Biezenbos ◽

Roelien H. Enting ◽

...

Keyword(s):

Spinal Cord ◽

Motor Function ◽

Operative Treatment ◽

Meta Analysis ◽

Postoperative Outcome ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Spinal Cord Herniation ◽

Dura Defect ◽

Brown Sequard Syndrome

Abstract Objective: Anterior thoracic spinal cord herniation is a rare cause of progressive myelopathy. Much has been speculated about the best operative treatment. However, no evidence in favor of any of the promoted techniques is available to date. Therefore, we decided to analyze treatment procedures and treatment outcomes of anterior thoracic spinal cord herniation to identify those factors that determine postoperative outcome. Methods: An individual patient data meta-analysis was conducted, focusing on age, gender, vertebral segment of herniation, preoperative neurological status, operative interval, operative findings, operative techniques, intraoperative neurophysiological monitoring, postoperative imaging, neurological outcome and follow-up. Three cases from our own institution were added to the material collected. Bivariate analysis tests and multivariate logistic regression tests were used so as to define which variables were associated with outcome after surgical treatment of anterior thoracic spinal cord herniation. Results: Brown-Séquard syndrome and release of the herniated spinal cord appeared to be strong independent factors, associated with favorable postoperative outcome. Widening of the dura defect is associated with the highest prevalence of postoperative motor function improvement when compared with the application of an anterior dura patch (P < 0.036). Conclusion: Most patients with anterior thoracic spinal cord herniation require operative treatment because of progressive myelopathy. Patients with Brown-Séquard syndrome have a better prognosis with respect to postoperative motor function improvement. In this review, spinal cord release and subsequent widening of the dura defect were associated with the highest prevalence of motor function improvement. D-wave recording can be a very useful tool for the surgeon during operative treatment of this disorder.

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Effect of Segmental Artery Ligation on the Blood Supply of the Thoracic Spinal Cord During Anterior Spinal Surgery: A Quantitative Histomorphological Fresh Cadaver Study

Spine ◽

10.1097/01.brs.0000154622.49240.ff ◽

2005 ◽

Vol 30 (5) ◽

pp. 483-486 ◽

Cited By ~ 17

Author(s):

Lin Yuan ◽

G X. Ni ◽

K K. D. Luk ◽

K M. C. Cheung ◽

D S. Lu ◽

...

Keyword(s):

Spinal Cord ◽

Blood Supply ◽

Spinal Surgery ◽

Cadaver Study ◽

Artery Ligation ◽

Thoracic Spinal Cord ◽

Segmental Artery ◽

Fresh Cadaver ◽

Thoracic Spinal ◽

Anterior Spinal Surgery

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Intracranial Subdural Hematoma After Resection of a Thoracic Spinal Cord Tumor

Journal of Spinal Disorders & Techniques ◽

10.1097/00024720-200212000-00019 ◽

2002 ◽

Vol 15 (6) ◽

pp. 533-536 ◽

Cited By ~ 14

Author(s):

Atsuya Watanabe ◽

Hiroo Takai ◽

Shuhei Ogino ◽

Takeshi Ohki ◽

Isao Ohki

Keyword(s):

Spinal Cord ◽

Subdural Hematoma ◽

Spinal Cord Tumor ◽

Thoracic Spinal Cord ◽

Thoracic Spinal

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Solitary Fibrous Tumor of the Spinal Cord: Case Report and Review of the Literature

Neurosurgery ◽

10.1227/01.neu.0000130037.45768.84 ◽

2004 ◽

Vol 55 (2) ◽

pp. E433-E438 ◽

Cited By ~ 21

Author(s):

Mitsuhiro Kawamura ◽

Kazutaka Izawa ◽

Noboru Hosono ◽

Hiroshi Hirano

Keyword(s):

Spinal Cord ◽

Solitary Fibrous Tumor ◽

Spinal Cord Tumor ◽

Clinical Manifestations ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Spindle Cell Proliferation ◽

Long Term Follow Up ◽

Fibrous Tumor ◽

The Right

Abstract OBJECTIVE AND IMPORTANCE: A solitary fibrous tumor (SFT) is a rare neoplasm of probable mesenchymal origin that was first reported in the pleura but can occur in different sites. Only six cases of SFT arising from the spinal cord have been reported. CLINICAL PRESENTATION: We report a case of primary SFT occurring in the thoracic spinal cord in a 64-year-old man with Brown-Séquard syndrome. Magnetic resonance imaging revealed an intradural mass at the level of T2–T3. INTERVENTION: Total T2–T3 laminectomies were performed. The tumor appeared to be adherent to the right lateral aspect of the cord but not attached to the meninges. On histological examination, the tumor exhibited spindle cell proliferation with abundant dense collagen but without a hemangiopericytomatous pattern. Immunohistochemically, the tumor cells were reactive with CD34 and vimentin only. CONCLUSION: We report a rare case of SFT occurring in the thoracic spinal cord. Histologically and immunohistochemically, we confirmed the diagnosis of SFT. Low signal intensity on T1- and T2-weighted images corresponded to the histological findings. When a spinal cord tumor exhibits a signal pattern similar to this, SFT should be included in the differential diagnosis. Because of the rarity of reports on this condition, the clinical manifestations and course of SFT of the spinal cord are unknown, and careful long-term follow-up is recommended.

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