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06.12.2019 | Original Article - Spine - Other

Posterolateral myelotomy for intramedullary spinal cord tumors: the other way to do it?

verfasst von: Sotirios Katsigiannis, Anne Elisabeth Carolus, Kirsten Schmieder, Christopher Brenke

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Abstract

Background and purpose

To evaluate posterolateral myelotomy (PLM) as a surgical method for all cases of intramedullary spinal cord tumors (IMSCT) by assessing the surgical and functional outcomes of patients treated in our clinic.

Materials and methods

Patients with IMSCT who underwent surgery using PLM from 2013 to 2018 were reviewed retrospectively. Objective and quantitative assessment of the preoperative, postoperative, and follow-up neurological status was performed by using the modified McCormick functional schema and sensory pain scale.

Results

A total of 33 operations were performed on 27 patients who met the inclusion criteria. The mean grade on the McCormick functional schema increased insignificantly from 2.0 preoperatively to 2.3 immediately postoperatively and decreased back to 2.1 at the follow-up examination. Just one patient exhibited a transient proprioception deficit. Significant pain relief was observed as expressed in an improvement of mean grade on the sensory pain scale. Only in two cases was late neuropathic pain reported. A gross total resection/subtotal resection (GTR/STR) was achieved in all cases of hemangioblastoma and cavernoma, while for the majority of astrocytomas, only partial removal was accomplished. For ependymoma, which represents the most common IMSCT, a GTR/STR was realized in 12 cases (86%). A statistically significant difference (p = 0.027) was found when comparing the extent of tumor resection (EOR) between the two most common IMSCT, i.e., ependymoma and astrocytoma.

Conclusion

PLM may be considered a reliable surgical method for IMSCT, as it combines a satisfactory EOR with reduced risk of tissue damage and excellent pain relief.

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Titel: Posterolateral myelotomy for intramedullary spinal cord tumors: the other way to do it?
verfasst von: Sotirios Katsigiannis
Anne Elisabeth Carolus
Kirsten Schmieder
Christopher Brenke
Publikationsdatum: 06.12.2019
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-04151-5

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