Intramedullary spinal cord tumors: a review of current and future treatment strategies

Abstract

<jats:p>Intramedullary spinal cord tumors have low incidence rates but are associated with difficult treatment options. The majority of patients with these tumors can be initially treated with an attempted resection. Unfortunately, those patients who cannot undergo gross-total resection or have subtotal resection are left with few treatment options, such as radiotherapy and chemotherapy. These adjuvant treatments, however, are associated with the potential for significant adverse side effects and still leave patients with a poor prognosis. To successfully manage these patients and improve both their quality of life and prognosis, novel treatment options must be developed to supplement subtotal resection. New research is underway investigating alternative therapeutic approaches for these patients, including directed, localized drug delivery and nanomedicine techniques. These and other future investigations will hopefully lead to promising new therapies for these devastating diseases.</jats:p>

Minimally Invasive Surgical Approach for Spinal Canal Tumors—Technique Description and Experience from a Reference Center

“…Although there is a high survival rate, the tumor free period largely depends on the surgical approach. Astrocytomas are considered to have the worse prognosis amongst these types of lesions since their resection margin doesn't allow a complete resection in most cases, conditioning a recurrence rate of 47% [6] [7] [8]. In our case series, of two patients with astrocytomas, we accomplished one complete resection and one subtotal resection.…”

Three-dimensional Fluoroscopy-based Navigation for the Pedicle Screw Placement in Patients with Primary Invasive Spinal Tumors

“…[11] The treatment goals include the restoration and preservation of neurological function, pain relief, and local lesion control. [1617] Total resection is recommended because inadequate removal may be followed by recurrence. [111617] In our study, 39 of 51 patients showed significant symptoms’ improvement postoperatively based on McCormick classification, and 12 patients’ symptoms remained the same.…”

“…[1617] Total resection is recommended because inadequate removal may be followed by recurrence. [111617] In our study, 39 of 51 patients showed significant symptoms’ improvement postoperatively based on McCormick classification, and 12 patients’ symptoms remained the same. We further analyzed some factors that affect the surgical outcome, such as patients’ age and the duration of preoperative symptoms.…”

Análise Retrospectiva dos Tumores Intradurais de um Hospital Referência no Sul do Brasil

“…Neoplasias da medula espinhal são classificadas em 3 grupos de acordo com a sua localização anatômica em relação à duramáter (DM) em: extradurais, intradurais extramedulares e intradurais intramedulares 1 .…”

“…O respectivo trabalho focará nos tumores intradurais intramedulares, lesões que correspondem de 2-4% de todos os tumores do sistema nervoso central1 e a 8-10% dos tumores da medula espinhal 1,2 . Os gliomas são a variante histológica mais comum, sendo ependimoma o mais prevalente, seguido pelos astrocitomas que são os mais comuns em crianças [1][2][3] . Outras neoplasias menos frequentes incluem os hemangioblastomas, gangliogliomas, metástases, linfomas e outros, que podem acometer qualquer segmento da medula espinhal 3,4 .…”