scholarly journals Features and risk factors for recurrence of intradural spinal tumors

2019 ◽  
Vol 18 (1) ◽  
pp. 21-29
Author(s):  
V. A. Byvaltsev ◽  
I. A. Stepanov
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Neurological Deficit ◽  
Malignant Tumors ◽  
Significant Risk ◽  
Partial Resection ◽  
Spinal Tumors ◽  
Benign Tumors ◽  
Spinal Cord Tumors ◽  
Risk Factors For Recurrence

Spinal cord tumors include a variety of nosological units and are classified according to their localization and histological type. The search for literature sources in the Pubmed, EMBASE and eLibrary databases demonstrated the absence of studies devoted to study of the features and risk factors for the recurrence of intradural spinal tumors. the purpose of this study was to reveal features and risk factors of recurrence of intradural spinal tumors after microneurosurgical resection. material and methods. The study included medical records of 196 patients with intradural extramedullary and intramedullary spinal tumors. The extent of microneurosurgical tumor resection, clinical efficacy of surgery, and risk factors for recurrence of intradural spinal cord tumors were been analyzed. results. Improvement in neurologic deficit after surgery was noted in 116 (59.1 %) cases, neurologic status remained the same in 47 (24.0 %) patients, and worsening of neurological deficit was observed in 33 (16.8 %) cases. Total microneurosurgical resection of intradural spinal tumors was performed in 140 (71.4 %) patients, subtotal resection in 22 (11.2 %) patients, partial resection in 25 (12.7 %) patients and spinal cord decompression or biopsy and/or its roots were performed in 9 (4.6 %) of patients. The likelihood of recurrence-free survival of patients with benign intradural spinal cord tumors was significantly higher than that of patients with malignant tumors (p<0.001). Benign tumors (χ2=34.7, p<0.05), thoracic and lumbosacral tumors (χ2=10.3, p<0.05), low degree of neurological deficit (χ2=31.5, p<0.05), absence of syringomyelia/syringobulbia signs (χ2=13,2, p<0,05), as well as extramedullary tumors (χ2=12,6, p<0.05) allowed us to perform total degree microneurosurgical resection. Malignant tumors (χ2=34.8, p<0.05), cervical and thoracic tumors (χ2=8,4, p<0,05), high degree of neurological deficit (χ2=12,9, p<0.05), partial resection, biopsy or decompression of neural structures (χ2=9.7, p<0.05) and intramedullary tumors statistically significantly increased the risk of their recurrence. conclusion. Histological pattern, tumor localization, preoperative clinical and neurological deficit according to the McCormick classification and the extent of surgery are significant risk factors for recurrence of intradural spinal tumors.

The Association of Hydrocephalus with Intramedullary Spinal Cord Tumors: A Series of 25 Patients

Neurosurgery ◽  
1990 ◽  
Vol 27 (5) ◽  
pp. 749-754 ◽  
Author(s):  
Stephanie Rifkinson-Mann ◽  
Jeffrey H. Wisoff ◽  
Fred Epstein
Keyword(s):  
Spinal Cord ◽  
Malignant Tumors ◽  
Spinal Cord Tumor ◽  
Benign Tumors ◽  
High Grade ◽  
Spinal Cord Tumors ◽  
Increased Intracranial Pressure ◽  
Intramedullary Spinal Cord ◽  
Spinal Cysts ◽  
The Relationship

Abstract 171 patients with intramedullary spinal cord tumors were operated on, of which 25 patients (15%), mostly children, developed symptomatic hydrocephalus. Twenty patients (12%) had malignant tumors, with 13 of the 20 cases (63%) complicated by increased intracranial pressure and ventriculomegaly. Of the remaining 151 patients with benign tumors (89%), only 12 (8%) developed symptomatic hydrocephalus. In an effort to understand the relationship between hydrocephalus and intramedullary spinal cord tumor, the authors analyze the level and histology of the neoplasm, as well as its association with spinal cysts. A review of the neurosurgical literature reveals that 34 similar cases of hydrocephalus associated with intramedullary spinal cord tumors have been reported to date. The authors note that the presence of hydrocephalus in patients with malignant intramedullary astrocytomas is associated with a shorter rate of survival than in those patients with high-grade lesions but without hydrocephalus, apparently due to rapid tumor progression. The ventriculomegaly seen with benign spinal cord gliomas has no statistically significant effect upon longterm prognosis.

Risk factors for prolonged length of stay in patients undergoing surgery for intramedullary spinal cord tumors

2021 ◽  
Vol 91 ◽  
pp. 396-401
Author(s):  
Romaric Waguia ◽  
Timothy Y. Wang ◽  
Vikram A. Mehta ◽  
Luis Ramirez ◽  
Edwin McCray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Length Of Stay ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Prolonged Length

Risk factor analysis of progressive spinal deformity after resection of intramedullary spinal cord tumors in patients who underwent laminoplasty: a report of 105 consecutive cases

2019 ◽  
Vol 30 (5) ◽  
pp. 655-663 ◽  
Author(s):  
Wei Shi ◽  
Shan Wang ◽  
Huifang Zhang ◽  
Guoqin Wang ◽  
Yi Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Spinal Deformity ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord

OBJECTIVELaminoplasty has been used in recent years as an alternative approach to laminectomy for preventing spinal deformity after resection of intramedullary spinal cord tumors (IMSCTs). However, controversies exist with regard to its real role in maintaining postoperative spinal alignment. The purpose of this study was to examine the incidence of progressive spinal deformity in patients who underwent laminoplasty for resection of IMSCT and identify risk factors for progressive spinal deformity.METHODSData from IMSCT patients who had undergone laminoplasty at Beijing Tsinghua Changgung Hospital between January 2014 and December 2016 were retrospectively reviewed. Univariate tests and multivariate logistic regression analysis were used to assess the statistical relationship between postoperative spinal deformity and radiographic, clinical, and surgical variables.RESULTSOne hundred five patients (mean age 37.0 ± 14.5 years) met the criteria for inclusion in the study. Gross-total resection (> 95%) was obtained in 79 cases (75.2%). Twenty-seven (25.7%) of the 105 patients were found to have spinal deformity preoperatively, and 10 (9.5%) new cases of postoperative progressive deformity were detected. The mean duration of follow-up was 27.6 months (SD 14.5 months, median 26.3 months, range 6.2–40.7 months). At last follow-up, the median functional scores of the patients who did develop progressive spinal deformity were worse than those of the patients who did not (modified McCormick Scale: 3 vs 2, and p = 0.04). In the univariate analysis, age (p = 0.01), preoperative spinal deformity (p < 0.01), extent of tumor involvement (p < 0.01), extent of abnormal tumor signal (p = 0.02), and extent of laminoplasty (p < 0.01) were identified as factors associated with postoperative progressive spinal deformity. However, in subsequent multivariate logistic regression analysis, only age ≤ 25 years and preoperative spinal deformity emerged as independent risk factors (p < 0.05), increasing the odds of postoperative progressive deformity by 4.1- and 12.4-fold, respectively (p < 0.05).CONCLUSIONSProgressive spinal deformity was identified in 25.7% patients who had undergone laminoplasty for IMSCT resection and was related to decreased functional status. Younger age (≤ 25 years) and preoperative spinal deformity increased the risk of postoperative progressive spinal deformity. The risk of postoperative deformity warrants serious reconsideration of providing concurrent fusion during IMSCT resection or close follow-up after laminoplasty.

Analysis of implementiation of 4th Head and Neck Cancer Awareness Week in Department of Otolaryngology in Międzyleski Hospital in Warsaw

2017 ◽  
Vol 71 (5) ◽  
pp. 1-5
Author(s):  
Karolina Dżaman ◽  
Karolina Piskadło–Zborowska ◽  
Mirosława Pietniczka–Załęska
Keyword(s):  
Risk Factors ◽  
Neck Cancer ◽  
Malignant Tumors ◽  
Study Patient ◽  
Benign Tumors ◽  
Cancer Awareness ◽  
Multiple Sexual Partners ◽  
Oncological Treatment ◽  
Public Consciousness ◽  
Risk Patients

Introduction: The aim of the study was to analyze the profile of patients applying for free preventive examinations within The Forth European Head an Neck Cancer (HNC) Awareness Week in the Department of Otorhynolaryngology in Międzyleski Hospital in Warsaw (ORL MSS). Material and methods: A media campaign was designed to inform HNC risk patients about the opportunity to receive free preventive examinations in ORL MSS. 225 patients were enrolled to the study. Patient age ranged from 26 to 92 (average 63 years). Women accounted for 66% (149) and males 34% (76). Each patient completed a questionnaire assessing risk factors for HNC, including reported symptoms and lifestyle. ENT examination was performed. Some patients were referred for further diagnostics and treatment. Results: The following HNC risk factors connected with lifestyle were found: nicotine in 22%, alcohol in more than once a week in 12%, oral sex in 17%, multiple sexual partners in 10%, rare dental tests in 24%, prosthetic restorations in 45%. The symptom that most often prompted patients to participate in the HNC prevention week was chronic hoarseness (64%) of people, dry mouth (39%), swallowing (37%), nasal obstruction (6%), neck tumour (5%). One per every five patients was referred to further diagnostics: imaging screening 7% (15 persons), fiber optic examination 11% (25 persons), the excision of the lesion 8% (18 persons). 17 patients were referred for further oncological treatment, of which 13 had benign tumors and 4 had malignant tumors. Conclusions: The HNC Awareness Program increases public consciousness and should systematically includes people with risk factors. The introduction of the Program in the ORL Department has made possible to detect and treat cancer in early stages in 7.5% of those who applied for the program. The use of adequate diagnostics and treatment requires, however, adequate financial resources and systemic solutions.

The development of techniques for resection of spinal cord tumors by Harvey W. Cushing

2005 ◽  
Vol 2 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Dennis D. Spencer ◽  
William E. Krauss
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Spinal Tumors ◽  
Spinal Cord Tumors ◽  
Content Type ◽  
Improved Outcomes ◽  
Peter Bent Brigham Hospital ◽  
Operative Notes ◽  
Natural Histories ◽  
Fine Print

✓ Harvey Cushing's refinement of Halsted's meticulous surgical techniques facilitated safe resection of intradural spinal tumors. Although Cushing focused his attention on brain tumors at the Peter Bent Brigham Hospital, his numerous contributions to the treatment of intradural spinal tumors include the description of these tumors' natural histories and their histological classifications. The application of his experienced intracranial techniques to the resection of spinal tumors improved outcomes. The authors review selected operative notes and sketches to demonstrate his technique in the excision of the spinal cord tumors.

Intraoperative Spinal Navigation for the Removal of Intradural Tumors: Technical Notes

2017 ◽  
Vol 15 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Roberto Stefini ◽  
Stefano Peron ◽  
Jaime Mandelli ◽  
Elena Bianchini ◽  
Paolo Roccucci
Keyword(s):  
Spinal Cord ◽  
Spinous Process ◽  
Pedicle Screws ◽  
Skin Incision ◽  
Spinal Tumors ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Extramedullary Tumor ◽  
Spinal Navigation ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND In recent years, spinal surgery has incorporated the many advantages of navigation techniques to facilitate the placement of pedicle screws during osteosynthesis, mainly for degenerative diseases. However, spinal intradural tumors are not clearly visible by intraoperative fluoroscopy or computed tomography scans, thereby making navigation necessary. OBJECTIVE To evaluate the use of spinal navigation for the removal of intradural and spinal cord tumors using spinal magnetic resonance imaging (MRI) merged with intraoperative 3-dimensional (3-D) fluoro images. METHODS After fixing the patient reference frame on the spinous process, the 3-D fluoro images were obtained in the surgical room. Using this image as the reference, the preoperative volumetric MRI images and intraoperative 3-D fluoro images were merged using automated software or manually. RESULTS From January to July 2016, we performed 10 navigated procedures for intradural spinal tumors by merging MRI and 3-D fluoro images. Nine patients had an intradural extramedullary tumor, 6 had neurinomas, and 3 had meningiomas; 1 patient had an intramedullary spinal cord metastasis. CONCLUSION The surgically demonstrated benefits of spinal navigation for the removal of intradural tumors include the decreased risk of surgery at the wrong spinal level, a minimal length of skin incision and muscle strip, and a reduction in bone removal extension. Furthermore, this technique offers the advantage of opening the dura as much as is necessary and, in the case of intrinsic spinal cord tumors, it allows the tumor to be centered. Otherwise, this would not be visible, thus enabling the precise level and the posterior midline sulcus to be determined when performing a mielotomy.

scholarly journals LOCALIZATION AND HISTOLOGICAL STRUCTURE OF SPINAL CORD TUMORS IN PATIENTS IN SUMY REGION

2019 ◽  
Vol 7 (4) ◽  
pp. 372-376
Author(s):  
O. O. Potapov ◽  
O. P. Kmyta ◽  
O. O. Tsyndrenko ◽  
N. O. Dmytrenko ◽  
E. V. Kolomiets ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Diagnosis And Treatment ◽  
Surrounding Tissue ◽  
Spinal Tumors ◽  
Histological Structure ◽  
Spinal Cord Tumors ◽  
Primary Tumors ◽  
Intradural Tumor ◽  
The Brain

Spinal cord tumors include tumors developing from its parenchyma, vessels, roots and membranes. The main theory of the formation of spinal cord tumors is the polyetiological dysontogenetic theory. According to this theory, hereditary factors, dysembriogenesis, trauma, carcinogenic effects, viral infection, intoxication, radiation, etc. play an important role in the development of tumors. Although scientists keep finding out more about genetic and environmental factors influencing the development of many types of tumors, spinal tumors are still a relatively unknown subject. Spinal tumors partially contain pathological genes, but in many cases, researchers don't know what causes these genetic changes. Tumors of the central nervous system (CNS) make up 12% of all tumors, tumors of the spinal cord – 3% of nervous system disorders, in the structure of malignant lesions of the CNS – 1,4-5%, occur mainly at the age of 20-60 years. In children, as well as in elderly and senile persons, these tumors are rare. Most often, they develop not from the brain matter, but from the surrounding tissue, and when they increase in size, they compress the spinal cord. Spinal tumors are usually divided into primary and secondary. The group of primary tumors include tumors, originating from the brain matter (intramedullar tumors), and those that grow from the membranes of the brain, roots, vessels (extramedullar tumors). Extramedullar tumors are much more common (in 80% of all spinal tumors) than intramedullar tumors. Extramedullar tumors can be both subdural and epidural. The majority of extramedullar tumors are subdural. Occasionally there are tumors, some of which are located inside the dural sac, and some – outside the dura mater, they are subdural-epidural tumors, as well as epidural-extrovertebral tumors. Among extramedullar tumors the most commonly diagnosed are meningiomas and neurinomas, among intramedullar the most common are ependymomas, less common are astrocytomas and oligodendroglioma. Glioblastomas of the spinal cord is extremely rare; the most common metastases from the posterior fossa are medulloblastomas. Intracerebral tumors of the spinal cord are characterized by greater biological benignity, than similar brain tumors. Extracerebral spinal cord tumors have no such differences in their biological properties. In general, spinal cord tumors are more common in elderly patients. Neurinomas and meningiomas predominate in adults, and ependymomas and dysgenetic tumors (teratoma, epidermoid cysts) – in children. Peculiarities of etiopathogenetic aspects, clinical course, influence on socio-economic factors encourage further improvement of diagnosis and more detailed study of this type of tumors. Materials and methods. The analysis of medical records of patients with spinal cord tumors, who were hospitalized in neurological departments of the Sumy Regional and 4th City Clinical Hospitals in 2015-2018 was carried out. 69 clinical cases were processed in order to investigate the prevalence of spinal cord tumors in the Sumy region, the characteristics of the disease in this group of patients, the leading symptoms, methods of diagnosis and treatment. The analysis of statistical data, obtained after processing of the research materials, was carried out using the licensed version of the IBM SPSS Statistics 17 software. Our study significantly established that, according to the histological structure, in 46 patients (28 women and 18 men) meningiomas were predominant and that in 31 patients they were located at the level of Th6-Th12. Mainly in 42 patients (33 women and 9 men, p<0.05) spinal cord neoplasms were localized at the level of Th6-Th12, with extramedular-intradural tumor location – 57 patients (38 women and 19 men). According to our study, pain syndrome significantly prevailed in 42 patients (35 with extramedular-intradural tumor localization). The study of the histological structure of tumors depending on their localization is an integral part of both diagnosis and treatment, and an important component of predicting the quality of life of the patient.

Neuroprotection for Aortic Surgery and Stenting

2017 ◽  
Author(s):  
Jared W. Feinman ◽  
John G. Augoustides
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Best Practices ◽  
Clinical Setting ◽  
Aortic Surgery ◽  
Surgical Techniques ◽  
Significant Risk ◽  
Severe Injury ◽  
The Brain

Despite recent advances, aortic surgery and stenting for an array of diseases still pose a significant risk of permanent and severe injury to the brain and/or spinal cord. These neurological risks are best understood in terms of the primary disease pathology, the extent of aortic involvement, mechanisms and risk factors, the role of neuromonitoring modalities, and the surgical techniques required for repair. This chapter will present an overview of perioperative practice in aortic surgery and stenting based on this framework and the latest guidelines and trials in order to describe best practices and promising options for neuroprotection in this challenging clinical setting.

scholarly journals Incidence, histopathology, and surgical outcome of tumors of spinal cord, nerve roots, meninges, and vertebral column-Data based on single institutional (Sher-i-Kashmir Institute of Medical Sciences) experience

2016 ◽  
Vol 07 (03) ◽  
pp. 381-391 ◽  
Author(s):  
Abdul Rashid Bhat ◽  
Altaf Rehman Kirmani ◽  
Muhammed Afzal Wani ◽  
Mohammed Haneef Bhat
Keyword(s):  
Spinal Cord ◽  
Surgical Outcome ◽  
Elderly Population ◽  
Spinal Tumors ◽  
Benign Tumors ◽  
Medical Sciences ◽  
Community Based ◽  
Metastatic Lesions ◽  
Primary Bone ◽  
Better Than

ABSTRACT Context: In the absence of a community-based study on the spinal tumors in the Valley, medical records of the only Regional Neurosurgical Center are available. Aim: The aim of this study is to establish a hospital-based regional epidemiology of spinal tumors in the Valley since the data are derived from a single institution. Materials and Methods: A retrospective analysis of 531 malignant and nonmalignant tumors of spinal cord, its coverings and vertebrae, which were managed in a Regional Neurosurgical Center under a standard and uniform medical-protocol over 30-year period from 1983 to 2014. Results: The hospital-based incidence for all spinal tumors was 0.24/100,000 persons per year. The malignant spinal cord and vertebral tumors comprised 32.58% (173/531) of all tumors, and benign spinal cord and vertebral tumors comprised 67.42% (358/531). The extradural–intradural tumors such as metastatic lesions and primary malignant vertebral tumors were on rise with 16.38% (87/531) cases. The children below 18 years were 5.46% (29/531), of which 55.17% (16/29) were below 9 years. The most common primary bone malignancy was multiple myeloma (54.54% =12/22). Histopathologically, the most common metastatic deposit in the spinal canal was non-Hodgkin's lymphoma (24.61% =16/65). A mortality of 3.20% (17/531) was noted. Recurrences were noted in 4.90% (26/531), and adjuvant therapies were given to 16.38% (87/531) patients. Conclusion: The malignant spinal cord and vertebral tumors, especially metastatic deposits, are on rise in elderly population. The surgical outcome, in terms of recovery and spinal stability, of benign tumors, is comparatively better than malignant ones. The study reveals a low regional incidence (hospital-based) of spinal tumors.

scholarly journals Surgical outcome of intradural extramedullary spinal cord tumors - Our experience at a tertiary health care center

2020 ◽  
Vol 1 (2) ◽  
pp. 103-109
Author(s):  
Gyanendra Joshi ◽  
Binod Bijukachhe ◽  
Javed Ahmad Khan
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Clinical Results ◽  
Spinal Tumors ◽  
Myxopapillary Ependymoma ◽  
Spinal Cord Tumors ◽  
Vas Score ◽  
Post Surgery ◽  
Intradural Extramedullary

Introduction: To report the treatment results of 19 patients who underwent excision of intradural extramedullary (IDEM) spinal tumors. Materials & Methods:  This is a retrospective study. Patients’ records were retrieved from the electronic database of Grande International Hospital. There were 19 IDEM spinal tumors excised over a period of 6 years between January 2013 and August 2019 by a single surgeon. There were 11 (57.9%) males and 8 (42.1%) females with an average age of 48.37±21.87 years (range, 5-79 years). The mean postoperative follow-up period was 12.87±14.88 months (range, 15 days - 60 months). The histopathological findings, locations of the tumors, and clinical results were analyzed. Neurological findings were evaluated using ASIA grading system and pain was evaluated using VAS score. Results:  Histopathologically the tumors were: 8 meningioma (42.1%), 4 schwannoma (21.1%), 4 neurofibroma (21.1%), 1 dermoid cyst (5.3%), 1 lipoma (5.3%), and 1 myxopapillary ependymoma (5.3%). Tumor locations were: dorsal in 10 (52.6%), lumbar in 5 (26.3%), lumbosacral in 2 (10.5%), dorsolumbar in 1 (5.3%), and cervical in 1 (5.3%) patient. Neurologic status of 7 patients was normal and 12 had neurologic involvement with 3 patients having Cauda Equina Syndrome (CES) preoperatively. At the final follow-up, 3-grade, 2-grade and 1-grade improvement in ASIA score was observed in 1, 6 and 1 cases, respectively. There was no change in the ASIA grade in 1 case. All 3 cases of CES achieved full neural recovery. Preoperative VAS score was 9.21±1.08 and improved significantly to 0.74±1.62 after surgery. Neurological improvement was seen in 91.67% with complete recovery in 75% of the cases and not a single case deteriorated neurologically post-surgery. Conclusion:  Most intradural-extramedullary spinal cord tumors are mostly benign and good clinical results can be obtained when adequately treated with surgery.

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