Results

Our service has operated on approximately 800 patients with intramedullary spinal cord tumors over a 20 year period. Recently a report about a subset of over 160 children with spinal cord tumors was published in one of the neurosurgical journals. Close to 80 % of these patients had low grade tumors, i.e. benign slow growing tumor types. In about 75% of these operations the tumor was removed to 95% or better. Two thirds of these patients had roughly the same neurological exam before and after surgery, about 25% were worse, about 15 % improved.

Over 75% of the patients with low grade tumorshad no progression over 5 years but only 30 % of the children with high-grade tumors. This was in principle similar to children under three years of age. The same principles apply to adult patients with intramedullary tumors. For adults the histologic diagnosis is particularly important: Ependymomas are surgically curable in the majority of cases. Astrocytomas can be controlled with a significant resection. Rare tumors such as Hemangioblastomas can also be surgically cured.

Overtly malignant spinal cord tumorsare fortunately rare. However, they tend to be aggressive lesions and progress in spite of resection followed by radiation therapy. The most important principles in terms of outcome are:

Early diagnosis and early surgery, i.e. before the onset of significant neurological dysfunction carries the most favorable neurological prognosis for all spinal cord tumor operations.

Ependymomas can be completely resected and cured in the majority of patients.

Astrocytomas can be surgically controlled in the majority of patients.

Peter Semczuk,