Abstract
Technological innovations in spinal intradural tumor surgery simplify treatment. Surgical treatment of cranial benign and malignant pathologies under microscope with sodium (Na)-fluorescein guidance has often been reported, but few studies have focused on spinal intradural tumors. We aimed to investigate the usefulness of Na-fluorescein under yellow filter in intradural spinal tumor surgery by retrospectively reviewing cases involving intramedullary and extramedullary tumors operated under the guidance of Na-fluorescein. Forty-nine adult patients with a diagnosis of spinal intradural tumor operated under a yellow filter (560 nm) microscope using Na-fluorescein dye were included in the study. Demographic data, such as age and sex, neurological status, extent of tumor resection, histopathological diagnosis, Na-fluorescein staining pattern, and its usefulness during surgery were noted and statistically analyzed. Of all recruited patients, 26 women (53.1%) and 23 men (46.9%), were included for analysis. The age range of the patients was 18–64 years, with a mean age of 41.6 ± 13.9. An intradural intramedullary mass was found in 30.6% (n = 15) of the patients, and an intradural extramedullary mass in 69.4% (n: 34). While Na-fluorescein staining was homogeneous in all intradural extramedullary tumors, 73.3% (n: 11) of intradural intramedullary tumors were homogeneous, and 13.3% (n: 2) moderately heterogeneous. In the whole study group, the Na-fluorescein staining pattern was helpful in surgical resection in 47 cases (95.9%). While 34/34 (100%) found it helpful for extramedullary tumors, 13/15 (86.7%) did in intramedullary tumors, and for 2/15 (13.3%) it was not. In conclusion, Na-fluorescein helps in distinguishing tumor from healthy tissue in intradural extramedullary and intramedullary tumor surgery under a yellow filter microscope in most cases, thus providing convenient assistance to surgeons.
Highlights
Spinal intradural tumors are rare central nervous system (CNS) diseases categorized as intramedullary and extramedullary according to their location
An intradural intramedullary mass was found in 30.6% (n: 15) of patients, and intradural extramedullary mass in 69.4% (n = 34)
Age and gender distribution did not differ between patients with intradural intramedullary and intradural extramedullary masses
Summary
Spinal intradural tumors are rare central nervous system (CNS) diseases categorized as intramedullary and extramedullary according to their location Treatment of these pathologies is surgical, and in recent years effective results have resulted in tumor surgery from the use of technological innovations. Surgery under the guidance of Sodium-fluorescein (Na-fluorescein) has Sodium Fluorescein for Spinal Tumors earned a place in neurosurgery for tumor resection and tumor volume reduction This technique, widely used in intracranial malignant and benign tumor surgery, provides an advantage to the surgical team by staining the tumor tissue in cases where the blood-brain barrier is disrupted [11,12,13,14,15,16]. Considering the number of published articles evaluating the use of Na-fluorescein in intracranial CNS tumors, this number is very low, pointing to a gap in knowledge we aimed to fill with the data gathered in this study
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
