eMedicine Specialties > Neurosurgery > Neoplasm

Spinal Cord Tumors - Management of Intradural Intramedullary Neoplasms: Follow-up

Author: James S Harrop, MD, Associate Professor, Departments of Neurological and Orthopedic Surgery, Jefferson Medical College
Coauthor(s): Ashwini D Sharan, MD, Assistant Professor of Neurosurgery, Assistant Professor of Neurology, Thomas Jefferson University School of Medicine
Contributor Information and Disclosures

Updated: May 27, 2009

Outcome and Prognosis

The 5-year survival rate for patients with benign or low-grade spinal cord neoplasms is greater than 90%. A patient's overall prognosis depends on the neoplasm's histopathology. In Brotchi's series of 239 patients with low-grade spinal tumors and operative intervention, 5% worsened, 50% stabilized, and 40% improved.1 A patient's neurologic function after surgical intervention directly depended on his or her preoperative neurological status. Therefore, the goal of surgical treatment is to prevent further neurologic dysfunction from compression by the neoplasm, to obtain a diagnosis, and to potentially cure the neoplastic condition with a complete resection.

Future and Controversies

Intraoperative microscopy, neurophysiologic monitoring, and improved neuroimaging have improved the success of surgical intervention. Further advances in technology for tumor resection and neuroimaging may lead to further improvements in surgical outcomes. Better understanding of the genetics of these neoplasms may provide for earlier medical intervention with improved care and treatment of these disorders.

Radiosurgical techniques, specifically the use of stereotactic radiosurgery or IMRT, are improving such that these options will have an increased role in the treatment of benign disease and more aggressive neoplasms. The difficulty with this modality is that a histologic diagnosis should be obtained prior to deciding on treatment.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of Jennifer Malone, MD, to the development and writing of this article.



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References
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References

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Further Reading

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Keywords

spinal cord tumors, spinal tumors, spinal cord neoplasms, spinal neoplasms, intramedullary spinal cord tumor, intradural neoplasms, intradural tumors, intramedullary neoplasms, spine tumors, glial cell neoplasms, glial cell tumors, astrocytomas, ependymomas, hemangioblastomas, paragangliomas, oligodendrogliomas, gangliogliomas, schwannomas, meningiomas, neurofibromas, intradural intramedullary neoplasms

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Contributor Information and Disclosures

Author

James S Harrop, MD, Associate Professor, Departments of Neurological and Orthopedic Surgery, Jefferson Medical College
James S Harrop, MD is a member of the following medical societies: American Association of Neurological Surgeons, American College of Surgeons, American Spinal Injury Association, Cervical Spine Research Society, Congress of Neurological Surgeons, and North American Spine Society
Disclosure: Depuy spine Consulting fee Consulting; Medtronic Consulting fee Consulting; stryker spine Honoraria Speaking and teaching

Coauthor(s)

Ashwini D Sharan, MD, Assistant Professor of Neurosurgery, Assistant Professor of Neurology, Thomas Jefferson University School of Medicine
Ashwini D Sharan, MD is a member of the following medical societies: American Medical Association, Association for the Advancement of Medical Instrumentation, Congress of Neurological Surgeons, and Movement Disorders Society
Disclosure: Nothing to disclose.

Medical Editor

Scott C Dulebohn, MD, Neurological Surgeon, Appalachian Neurosurgical
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Allen R Wyler, MD, Former Medical Director, Northstar Neuroscience, Inc
Allen R Wyler, MD is a member of the following medical societies: American Academy of Neurological and Orthopaedic Surgeons, American Association of Neurological Surgeons, and Society of Neurological Surgeons
Disclosure: Nothing to disclose.

CME Editor

Paolo Zamboni, MD, Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy
Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences
Disclosure: Nothing to disclose.

Chief Editor

Allen R Wyler, MD, Former Medical Director, Northstar Neuroscience, Inc
Allen R Wyler, MD is a member of the following medical societies: American Academy of Neurological and Orthopaedic Surgeons, American Association of Neurological Surgeons, and Society of Neurological Surgeons
Disclosure: Nothing to disclose.

 
 
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