Intramedullary spinal cord glial tumours: Management philosophy and surgical outcome
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Date
2006
Journal Title
Journal ISSN
Volume Title
Publisher
MINIMALLY INVASIVE NEUROSURGERY AND MULTIDISCIPLINARY NEUROTRAUMATOLOGY
Abstract
A retrospective analysis of 88 consecutive cases of intramedullary glial tumours, which constituted 58% of 149 cases of intramedullary lesions surgically managed over a 22-year period, is presented. Fifty-six astrocytomas and 32 ependymomas formed the group, which comprised 55 males and 33 females. While majority of the astrocytomas were in the cervical or cervicodorsal location (70%), it was almost equally distributed between the cervical and conus regions in 23 cases of ependymomas. The management philosophy has changed over the years from biopsy to total removal for ependymomas and a generous inside out decompression in case of astrocytomas. While only a biopsy or decompression was done in 35 of the earlier patients of astrocytomas a radical removal (subtotal in 18 and total in 3) could be achieved in 21 of our recent patients. We could achieve total resection in all the last 17 patients of ependymomas. Low grade astrocytomas radically removed and all ependymomas were not given radiotherapy. Out of the 39 patients of astrocytomas who are in follow up, 13 have improved, 19 remaining static and 7 have deteriorated. While only three of the 25 patients of ependymomas on long term follow up have deteriorated 18 have improved and 6 are remaining static. Conclusion: Although total resection of ependymomas have become a procedure with good functional results in most hands, a radical resection can be achieved with long term stabilisation of neurological deficits in majority of astrocytomas.
Description
Keywords
Neurosciences & Neurology; Surgery
Citation
,;36-+