Surgical treatment and prognostic factors of cervical intramedullary spinal cord tumors

Abstract

Objective To summarize our experience in surgical treatment of cervical intramedullary spinal cord tumors and to identify the prognostic factors associated with postoperative neurological status.Methods The clinical data of 65 consecutive patients with cervical intramedullary spinal cord tumors undergoing operation between Jan.2009 and Dec.2013 were retrospectively reviewed.McCormick Scale was applied to evaluate the preoperative and postoperative neurological functions.Multivariate logistic regression analysis was used to determine the independent prognostic factors of postoperative neurological status.Results Laminectomy was performed in 61 patients and unilateral multilevel interlaminar fenestration(UMIF)was applied in 4patients.Of all the 65 patients,48received total resection,4received subtotal resection and 13 received partial resection.The follow-up time was from 4 months to 15 years.The median follow-up time was 68 months.The clinical symptoms were relieved in 42 patients after operation,maintained unchanged in 14 and aggravated in 9.The pain remission rate of the patients was the highest(82.4%),followed by the sphincter dysfunction remission rate(68.8%),and the sensory disturbance remission rate of the patients was the lowest(39.6%).Based on McCormick Scale,the postoperative neurological functions was improved in 18patients(27.7%)and maintained unchanged in 39(60%),while eight patients(12.3%)developed neurological deterioration. Multivariate logistic regression analysis revealed that good preoperative neurological function(OR=19.87,95% CI:4.10-96.23,P=0.000)and total resection(OR=7.40,95% CI:1.34-40.95,P=0.022)were the independent protective factors for postoperative neurological status.Conclusion Microsurgical resection is the firstline treatment for cervical intramedullary spinal cord tumors,which can achieve a satisfying outcome in most cases.Preoperative neurological status and surgical extent are significantly associated with the postoperative functional outcome of patients.