Contemporary management of adult intramedullary spinal tumors—pathology and neurological outcomes related to surgical resection
Study Design Retrospective chart review and review of the recent literature. Objectives To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcome...
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| Veröffentlicht in: | Spinal cord 2008-08, Vol.46 (8), p.540-546 |
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| creator | Manzano, G Green, B A Vanni, S Levi, A D |
| description | Study Design
Retrospective chart review and review of the recent literature.
Objectives
To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD).
Setting
University of Miami/Jackson Memorial Medical Center Miami, FL, USA.
Methods
We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005.
Results
Histologic analysis revealed a predominance of ependymomas (50%) with astrocytomas only comprising 12.5% of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6% of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity.
Conclusion
We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence. |
| doi_str_mv | 10.1038/sc.2008.51 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_904462924</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1526844901</sourcerecordid><originalsourceid>FETCH-LOGICAL-c512t-a2926d166928ac2da1b2461e31f01869d9a1f00ac665707f186e4e803667cd343</originalsourceid><addsrcrecordid>eNp90c2KFDEQAOAgiruuXnwACYIKSo_563TnKIN_sOBFzyGbrh576U7aVHLYm76DT-iTmGYGF0Q8pZL6SCVVhDzmbMeZ7F-j3wnG-l3L75BzrjrdtFqouzWWWjRKGnlGHiBeM8YMN_19csb7Vglm9Dn5sY8hw7LG5NINXVxwB1ggZBpH6oYyZzqFnNwCNZ43gusU3ExzWWLCX99_ri5_jXM83FAXBhqgpG03-WpiyT4ugDTB7DIMNEeKJR2TCRB8nmJ4SO6NbkZ4dFovyJd3bz_vPzSXn95_3L-5bHzLRW6cMEIPXGsjeufF4PiVUJqD5CPjvTaDcTVizmvddqwb6xko6JnUuvODVPKCvDjeu6b4rQBmu0zoof4qQCxoDVNK1yKbfP5fqY1ikglR4dO_4HUsqbYHrRBGKtWxtqKXR-RTREww2jVNS22l5cxu87Po7TY_2_KKn5xuLFe157f0NLAKnp2Aw9rGMbngJ_zjRC3YMtNX9-rosKbCAdLt0_5R9jcdMrOS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>229344705</pqid></control><display><type>article</type><title>Contemporary management of adult intramedullary spinal tumors—pathology and neurological outcomes related to surgical resection</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Manzano, G ; Green, B A ; Vanni, S ; Levi, A D</creator><creatorcontrib>Manzano, G ; Green, B A ; Vanni, S ; Levi, A D</creatorcontrib><description>Study Design
Retrospective chart review and review of the recent literature.
Objectives
To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD).
Setting
University of Miami/Jackson Memorial Medical Center Miami, FL, USA.
Methods
We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005.
Results
Histologic analysis revealed a predominance of ependymomas (50%) with astrocytomas only comprising 12.5% of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6% of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity.
Conclusion
We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sc.2008.51</identifier><identifier>PMID: 18542096</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anatomy ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Cerebrospinal fluid. Meninges. Spinal cord ; Ependymoma - pathology ; Ependymoma - physiopathology ; Ependymoma - surgery ; Female ; Follow-Up Studies ; Human Physiology ; Humans ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Microsurgery - methods ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurochemistry ; Neurologic Examination ; Neurology ; Neuropsychology ; Neurosciences ; Neurosurgery - methods ; Retrospective Studies ; review ; Spinal Cord Neoplasms - pathology ; Spinal Cord Neoplasms - physiopathology ; Spinal Cord Neoplasms - surgery ; Traumas. Diseases due to physical agents ; Treatment Outcome</subject><ispartof>Spinal cord, 2008-08, Vol.46 (8), p.540-546</ispartof><rights>Springer Nature Limited 2008</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Aug 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-a2926d166928ac2da1b2461e31f01869d9a1f00ac665707f186e4e803667cd343</citedby><cites>FETCH-LOGICAL-c512t-a2926d166928ac2da1b2461e31f01869d9a1f00ac665707f186e4e803667cd343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sc.2008.51$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sc.2008.51$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20535098$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18542096$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manzano, G</creatorcontrib><creatorcontrib>Green, B A</creatorcontrib><creatorcontrib>Vanni, S</creatorcontrib><creatorcontrib>Levi, A D</creatorcontrib><title>Contemporary management of adult intramedullary spinal tumors—pathology and neurological outcomes related to surgical resection</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study Design
Retrospective chart review and review of the recent literature.
Objectives
To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD).
Setting
University of Miami/Jackson Memorial Medical Center Miami, FL, USA.
Methods
We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005.
Results
Histologic analysis revealed a predominance of ependymomas (50%) with astrocytomas only comprising 12.5% of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6% of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity.
Conclusion
We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anatomy</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Ependymoma - pathology</subject><subject>Ependymoma - physiopathology</subject><subject>Ependymoma - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microsurgery - methods</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurochemistry</subject><subject>Neurologic Examination</subject><subject>Neurology</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>Neurosurgery - methods</subject><subject>Retrospective Studies</subject><subject>review</subject><subject>Spinal Cord Neoplasms - pathology</subject><subject>Spinal Cord Neoplasms - physiopathology</subject><subject>Spinal Cord Neoplasms - surgery</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><issn>1362-4393</issn><issn>1476-5624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp90c2KFDEQAOAgiruuXnwACYIKSo_563TnKIN_sOBFzyGbrh576U7aVHLYm76DT-iTmGYGF0Q8pZL6SCVVhDzmbMeZ7F-j3wnG-l3L75BzrjrdtFqouzWWWjRKGnlGHiBeM8YMN_19csb7Vglm9Dn5sY8hw7LG5NINXVxwB1ggZBpH6oYyZzqFnNwCNZ43gusU3ExzWWLCX99_ri5_jXM83FAXBhqgpG03-WpiyT4ugDTB7DIMNEeKJR2TCRB8nmJ4SO6NbkZ4dFovyJd3bz_vPzSXn95_3L-5bHzLRW6cMEIPXGsjeufF4PiVUJqD5CPjvTaDcTVizmvddqwb6xko6JnUuvODVPKCvDjeu6b4rQBmu0zoof4qQCxoDVNK1yKbfP5fqY1ikglR4dO_4HUsqbYHrRBGKtWxtqKXR-RTREww2jVNS22l5cxu87Po7TY_2_KKn5xuLFe157f0NLAKnp2Aw9rGMbngJ_zjRC3YMtNX9-rosKbCAdLt0_5R9jcdMrOS</recordid><startdate>20080801</startdate><enddate>20080801</enddate><creator>Manzano, G</creator><creator>Green, B A</creator><creator>Vanni, S</creator><creator>Levi, A D</creator><general>Nature Publishing Group UK</general><general>Nature Publishing</general><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080801</creationdate><title>Contemporary management of adult intramedullary spinal tumors—pathology and neurological outcomes related to surgical resection</title><author>Manzano, G ; Green, B A ; Vanni, S ; Levi, A D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-a2926d166928ac2da1b2461e31f01869d9a1f00ac665707f186e4e803667cd343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anatomy</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cerebrospinal fluid. Meninges. Spinal cord</topic><topic>Ependymoma - pathology</topic><topic>Ependymoma - physiopathology</topic><topic>Ependymoma - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microsurgery - methods</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurochemistry</topic><topic>Neurologic Examination</topic><topic>Neurology</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>Neurosurgery - methods</topic><topic>Retrospective Studies</topic><topic>review</topic><topic>Spinal Cord Neoplasms - pathology</topic><topic>Spinal Cord Neoplasms - physiopathology</topic><topic>Spinal Cord Neoplasms - surgery</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manzano, G</creatorcontrib><creatorcontrib>Green, B A</creatorcontrib><creatorcontrib>Vanni, S</creatorcontrib><creatorcontrib>Levi, A D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manzano, G</au><au>Green, B A</au><au>Vanni, S</au><au>Levi, A D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contemporary management of adult intramedullary spinal tumors—pathology and neurological outcomes related to surgical resection</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>46</volume><issue>8</issue><spage>540</spage><epage>546</epage><pages>540-546</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study Design
Retrospective chart review and review of the recent literature.
Objectives
To present our experience, over an 8-year period, with aggressive microsurgical resection of intramedullary spinal tumors in adults focusing on histology, microsurgical techniques, short-term neurological outcomes, complication avoidance and dorsal column dysfunction (DCD).
Setting
University of Miami/Jackson Memorial Medical Center Miami, FL, USA.
Methods
We conducted a retrospective review of a series of adult patients with intramedullary spinal tumors treated with microsurgical excision at the University of Miami/Jackson Memorial Medical Center between January 1997 and September 2005.
Results
Histologic analysis revealed a predominance of ependymomas (50%) with astrocytomas only comprising 12.5% of the tumors. We found no significant difference in pre- and postoperative McCormick grades. Although patients did not manifest significant motor weakness postoperatively as a result of surgery, 43.6% of patients exhibited the signs and symptoms of DCD, resulting in significant postoperative morbidity.
Conclusion
We present a contemporary adult series of intramedullary spinal tumors. The most significant postoperative morbidity experienced by patients was DCD. The neurosurgeon should recognize the impact of these symptoms, prepare the patient and his/her family for the possibility of DCD, and minimize dorsal column manipulation in an attempt to decrease its prevalence.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>18542096</pmid><doi>10.1038/sc.2008.51</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Anatomy Biological and medical sciences Biomedical and Life Sciences Biomedicine Cerebrospinal fluid. Meninges. Spinal cord Ependymoma - pathology Ependymoma - physiopathology Ependymoma - surgery Female Follow-Up Studies Human Physiology Humans Injuries of the nervous system and the skull. Diseases due to physical agents Magnetic Resonance Imaging Male Medical sciences Microsurgery - methods Middle Aged Nervous system (semeiology, syndromes) Neurochemistry Neurologic Examination Neurology Neuropsychology Neurosciences Neurosurgery - methods Retrospective Studies review Spinal Cord Neoplasms - pathology Spinal Cord Neoplasms - physiopathology Spinal Cord Neoplasms - surgery Traumas. Diseases due to physical agents Treatment Outcome |
| title | Contemporary management of adult intramedullary spinal tumors—pathology and neurological outcomes related to surgical resection |
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