Spinal Cord Tumor Surgery—Importance of Continuous Intraoperative Neurophysiological Monitoring After Tumor Resection

Spine ◽  
2012 ◽  
Vol 37 (16) ◽  
pp. E1001-E1008 ◽  
Author(s):  
Marie-Thérèse Forster ◽  
Gerhard Marquardt ◽  
Volker Seifert ◽  
Andrea Szelényi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Tumor Surgery

Spinal Cord Monitoring

2016 ◽  
pp. 798-832
Author(s):  
Jeffrey A. Strommen ◽  
Andrea J. Boon
Keyword(s):  
Spinal Cord ◽  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Neurophysiological Monitoring ◽  
Spinal Root ◽  
Compound Muscle Action Potentials ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Intraoperative neurophysiological monitoring is a valuable tool to preserve spinal cord and spinal root integrity during surgical procedures. A monitoring plan may include somatosensory evoked potentials (SEP), motor evoked potentials (MEP), compound muscle action potentials (CMAP), and electromyography (EMG). Such monitoring is individualized depending on the preoperative clinical deficit, the structures most at risk, and the surgical and anesthesia plan. The most common use of these techniques is in primary spine disease, where the spinal cord pathways will typically be monitored with both MEP and SEP. In cervical or lumbar spine surgeries, EMG monitoring will help protect the nerve root either during decompression or during pedicle screw placement. Monitoring during spinal cord tumor resection or vascular procedures (such as aortic aneurysm repair) not only helps prevent deficit, but also allows the surgeon to proceed with confidence and not unnecessarily terminate the procedure.

scholarly journals Vertebral plate and ligament composite laminoplasty in spinal cord tumor surgery: Analysis of 94 patients

2021 ◽  
Vol 12 (1) ◽  
pp. 040-045
Author(s):  
Xu Hao ◽  
Wang Lin
Keyword(s):  
Spinal Cord ◽  
Spinal Deformity ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Cervical Vertebra ◽  
Csf Leak ◽  
Tumor Surgery ◽  
Bone Fusion ◽  
Significant Difference ◽  
Similar Risk

Abstract Objectives The aim of this study was to evaluate the value and long-term effect of laminectomy or laminoplasty in spinal cord tumor surgery. Patients and methods Patients with spinal cord tumor treated in Department of Neurosurgery from January 2016 to October 2019 were included in this study. Posterior median approach tumor resection was preceded in 94 cases. Vertebral plate and ligament composite replant (laminoplasty group) was proceeded in 34 cases, and vertebral plate resection (laminectomy group) was proceeded in 60 cases. All patients were followed up and neurological function imagings were conducted 1 week, 3 months, and 6 months postsurgery to evaluate the surgical efficiency and spinal stability. Results Total resection was achieved in 84 patients (89.0%); subtotal resection was achieved in 10 patients (11%). There was no significant difference between thelaminectomy group and laminoplasty group in terms of operative time, surgical site, infection rate, cerebrospinal fluid (CSF) infection, CSF leak, and length of hospitalization (P > 0.05). The incidence of postoperative spinal deformity was 15.0% in the laminectomy group and 11.7% in the laminoplasty group (P > 0.05). Laminoplasty vs laminectomy was associated with a similar risk of progressive deformity. However, for the cervical patients, there is significant difference (P < 0.05) in the spinal deformity. For the patients with incision vertebral segments >3, there is no significant difference in the spinal deformity (P > 0.05). Bone fusion was achieved in 7 (20%) patients in the laminoplasty group. Laminoplasty vs laminectomy was associated with a similar risk of progressive deformity. Conclusion Vertebral plate and ligament composite replant is a simple and practical method in spinal cord tumor surgery. Neither every case got bone fusion nor positive results turned out in survival analysis, but it is still valuable in reducing spinal deformity, especially in cervical vertebra spinal cord tumor surgery.

Spinal Cord Tumor

2018 ◽  
pp. 141-148
Author(s):  
Rajiv R. Iyer ◽  
George I. Jallo
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Intraoperative Neuromonitoring ◽  
Neurological Dysfunction ◽  
Neurophysiological Monitoring ◽  
Intramedullary Spinal Cord ◽  
Dural Closure ◽  
Pilocytic Astrocytomas

Intramedullary spinal cord tumors (IMSCTs) are rare central nervous system lesions with heterogeneous patient presentations that often include pain and neurological dysfunction. In adults, ependymomas are the most common IMSCT, and in children, pilocytic astrocytomas are most frequent. The mainstay of treatment for IMSCTs is maximal safe surgical resection. Careful surgical planning and technique are critical for successful outcomes. This includes the choice of appropriate spinal levels for surgery, interpretation of real-time intraoperative neurophysiological monitoring, maintenance of meticulous hemostasis, careful microsurgical dissection, and watertight dural closure. Close attention to intraoperative neuromonitoring can allow for maximal tumor resection without permanent postoperative deficits in experienced hands. Transient postoperative deficits often improve with time. Aggressive resection often leads to excellent outcomes and should be attempted regardless of patient age.

The Evolution of Intramedullary Spinal Cord Tumor Surgery

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. ons84-ons92 ◽  
Author(s):  
Daniel M. Sciubba ◽  
Daniel Liang ◽  
Karl F. Kothbauer ◽  
Joseph C. Noggle ◽  
George I. Jallo
Keyword(s):  
Spinal Cord ◽  
New Technologies ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Surrounding Tissue ◽  
Tumor Surgery ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Spinal Cord Tumor

Abstract Objective: Resections of intramedullary spinal cord tumors were attempted as early as 1890. More than a century after these primitive efforts, profound advancements in imaging, instrumentation, and operative techniques have greatly improved the modern surgeon’s ability to treat such lesions successfully, often with curative results. Methods: We review the history of intramedullary spinal cord tumor surgery, as well as the evolution and advancement of technologies and surgical techniques that have defined the procedure over the past 100 years. Results: Surgery to remove intramedullary spinal cord tumors has evolved to include sophisticated imaging equipment to pinpoint tumor location, laser scalpel systems to provide precise incisions with minimal damage to surrounding tissue, and physiological monitoring to detect and prevent intraoperative motor deficits. Conclusion: Modern surgical devices and techniques have developed dramatically with the availability of new technologies. As a result, continual advancements have been achieved in intramedullary spinal cord tumor surgery, thus increasing the safety and effectiveness of tumor resection, and progressively improving the overall outcomes in patients undergoing such procedures.

The impact of intraoperative neurophysiological monitoring in spinal cord astrocytoma-surgery

2010 ◽  
Vol 41 (01) ◽  
Author(s):  
S Grossauer ◽  
V Tramontano ◽  
L Bruckmann ◽  
K Köck ◽  
G Sqintani ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
The Impact ◽  
Spinal Cord Astrocytoma
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