NEUROSURGICAL TREATMENT OF INTRAMEDULLAR TUMOR OF CERVICAL LOCATION

Abstract

Materials and methods. This report analyzes 47 patients who were operated on at Romodanov Neurosurgery Institute of the Academy of Medical Sciences of Ukraine in the period from 2010 to 2020 due to intramedullary tumors of the cervical spine.

Results. All patients with intramedullary tumors of the cervical spine were operated. According to the volume of tumor removal, operations with total (17 observations), subtotal (14 observations), and partial (19 observations) removal were distinguished. The removal of at least 95% of the tumor volume was considered total, which was confirmed by examination of the operating field under a microscope at the end of the operation or by early postoperative MRI.

Discussion. Total tumor removal is the gold standard in the surgical treatment of intramedullary spinal cord tumors. Ferrante L. et al reported that none of the patients who underwent total tumor resection had a recurrence, while 57.1% of patients with subtotal resection had a recurrence. The authors argue that the volume of the removed tumor is an important factor influencing the further prognosis. Total tumor resection can be recommended for most cases of intramedullary tumors of the cervical spinal cord. It is not possible to determine preoperatively whether total tumor removal is possible.

Conclusions. Intramedullary tumors of the cervical spine can be completely removed. Surgery should be performed immediately after diagnosis without expecting an increase in neurological deficit.