Surgical management and outcome of intramedullary spinal cord tumour
Abstract Objective Our aim is to assess the surgical management of intramedullary spinal cord tumours (IMSCTs) and evaluate factors associated with surgical outcomes in our hospitals. Patient and methods Between June 2013 and June 2016, a retrospective study was conducted on 16 consecutive cases of...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2019-01-01
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| Series: | Egyptian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41984-019-0028-9 |
| _version_ | 1817977657350946816 |
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| author | Mohammad Fathy Mohamed Keshk Ahmed El Sherif |
| author_facet | Mohammad Fathy Mohamed Keshk Ahmed El Sherif |
| author_sort | Mohammad Fathy |
| collection | DOAJ |
| description | Abstract Objective Our aim is to assess the surgical management of intramedullary spinal cord tumours (IMSCTs) and evaluate factors associated with surgical outcomes in our hospitals. Patient and methods Between June 2013 and June 2016, a retrospective study was conducted on 16 consecutive cases of IMSCTs. All patients provided their signed consent, and MRI was performed. The patients were surgically treated and were evaluated pre- and post-operatively by the modified McCormick scale (MMS). Appropriate statistical analysis was conducted. Results The mean patient age was 50.4 years, and the median follow-up was 15 months. The most common histological origin was ependymoma (n = 9, 56.25%). A cervical tumour was detected in eight patients, and a dorsal tumour was detected in seven. Post-operatively, the score was clinically but not statistically improved in seven cervical (87.5%) and four dorsal (57.1%) tumours (p = 0.334). Ten patients underwent total resection. Post-operative MMS scores showed improvement in all cases of total resection (n = 10, 100%). This improvement was clinically and statistically significant on last follow-up (p = 0.008). Fewer than four segments were involved in 9 cases, and more than four segments were involved in 7 cases. Post-operatively, all 9 patients (100%) with fewer than four involved segments improved, while only three patients (42.9%) with more than 4 involved segments improved (p = 0.019). Low-grade tumours such as ependymomas were correlated with good surgical outcomes, while high-grade tumours such as astrocytomas were correlated with poor surgical outcomes (p = 0.022). Conclusions Total tumour resection coupled with good preoperative clinical condition for tumours localised in the cervical or conus region predicts good neurological outcomes. Tumour localisation in the dorsal region with multi-segmental extension and high-grade tumour pathology predicts poor neurological outcomes. |
| first_indexed | 2024-04-13T22:19:43Z |
| format | Article |
| id | doaj.art-efe562c0e2f84774a752ac442abafb24 |
| institution | Directory Open Access Journal |
| issn | 2520-8225 |
| language | English |
| last_indexed | 2024-04-13T22:19:43Z |
| publishDate | 2019-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Journal of Neurosurgery |
| spelling | doaj.art-efe562c0e2f84774a752ac442abafb242022-12-22T02:27:20ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252019-01-013411710.1186/s41984-019-0028-9Surgical management and outcome of intramedullary spinal cord tumourMohammad Fathy0Mohamed Keshk1Ahmed El Sherif2Neurosurgery Departments, Al-Azhar UniversityNeurosurgery Departments, Al-Azhar UniversityNeurosurgery Departments, Al-Azhar UniversityAbstract Objective Our aim is to assess the surgical management of intramedullary spinal cord tumours (IMSCTs) and evaluate factors associated with surgical outcomes in our hospitals. Patient and methods Between June 2013 and June 2016, a retrospective study was conducted on 16 consecutive cases of IMSCTs. All patients provided their signed consent, and MRI was performed. The patients were surgically treated and were evaluated pre- and post-operatively by the modified McCormick scale (MMS). Appropriate statistical analysis was conducted. Results The mean patient age was 50.4 years, and the median follow-up was 15 months. The most common histological origin was ependymoma (n = 9, 56.25%). A cervical tumour was detected in eight patients, and a dorsal tumour was detected in seven. Post-operatively, the score was clinically but not statistically improved in seven cervical (87.5%) and four dorsal (57.1%) tumours (p = 0.334). Ten patients underwent total resection. Post-operative MMS scores showed improvement in all cases of total resection (n = 10, 100%). This improvement was clinically and statistically significant on last follow-up (p = 0.008). Fewer than four segments were involved in 9 cases, and more than four segments were involved in 7 cases. Post-operatively, all 9 patients (100%) with fewer than four involved segments improved, while only three patients (42.9%) with more than 4 involved segments improved (p = 0.019). Low-grade tumours such as ependymomas were correlated with good surgical outcomes, while high-grade tumours such as astrocytomas were correlated with poor surgical outcomes (p = 0.022). Conclusions Total tumour resection coupled with good preoperative clinical condition for tumours localised in the cervical or conus region predicts good neurological outcomes. Tumour localisation in the dorsal region with multi-segmental extension and high-grade tumour pathology predicts poor neurological outcomes.http://link.springer.com/article/10.1186/s41984-019-0028-9IntramedullarySpinal cord tumourModified McCormick scaleSpinal cordOutcome |
| spellingShingle | Mohammad Fathy Mohamed Keshk Ahmed El Sherif Surgical management and outcome of intramedullary spinal cord tumour Egyptian Journal of Neurosurgery Intramedullary Spinal cord tumour Modified McCormick scale Spinal cord Outcome |
| title | Surgical management and outcome of intramedullary spinal cord tumour |
| title_full | Surgical management and outcome of intramedullary spinal cord tumour |
| title_fullStr | Surgical management and outcome of intramedullary spinal cord tumour |
| title_full_unstemmed | Surgical management and outcome of intramedullary spinal cord tumour |
| title_short | Surgical management and outcome of intramedullary spinal cord tumour |
| title_sort | surgical management and outcome of intramedullary spinal cord tumour |
| topic | Intramedullary Spinal cord tumour Modified McCormick scale Spinal cord Outcome |
| url | http://link.springer.com/article/10.1186/s41984-019-0028-9 |
| work_keys_str_mv | AT mohammadfathy surgicalmanagementandoutcomeofintramedullaryspinalcordtumour AT mohamedkeshk surgicalmanagementandoutcomeofintramedullaryspinalcordtumour AT ahmedelsherif surgicalmanagementandoutcomeofintramedullaryspinalcordtumour |