Surgical Treatment of 660 Consecutive Cases of Spinal Cord Tumor / 中国微创外科杂志

ABSTRACT

Objective The purpose of this study was to evaluate the outcome of surgical treatment for spinal cord tumors. Methods We retrospectively analyzed a series of 660 patients with 676 intra-spinal tumors who were treated surgically from February 1993 to December 2007. The tumors located at the cervical level in 231 patients,thoracic in 202,lumbar in 159,sacral in 9,cervico-thoracic in 16,thoracico-lumbar in 42,and lumbar-sacral in 17. Totally 699 operations were performed,including posterior bilateral laminectomy approach in 599,unilateral laminotomy in 71 and laminoplasty in 6 cases.Besides,23 additional operations via lateral or ventral-lateral were performed for resection of extra-spinal component of dumbbell shaped tumors. Results In this series,Schwannomas and meningiomas were the most common extramedullary tumors accounting for 76.5% of the cases [517/676,rate of total resection 92.3% (477/517)]. The intra-medullary tumors accounted for 23.5% (159/676),in which astrocytomas and ependymomas were the most often observed [rate of total resection 67.3% (107/159)]. The peri-operative mortality was 1.7% (11/660). The motor and sensory functions were found to be improved after operation in 77.8% (357/459) and 79.2% (397/501) respectively. The sphincter function was improved in 72.4% (215/297). The rate of pain relief was 93.3% (361/387). The follow-up periods ranged from 0.5 to 15.1 years in 582 patients with an average of 5.9 years;during the period,87.8% (499/568) of the patients had an ASIA impairment scale E neurological function. Conclusions Intra-spinal tumors locate mostly in the subdural-extramedullary space,with a majority are Schwannomas and meningiomas. The widespread application and availability of MRI investigation provide the physician with accurate localization of the lesion thereafter ensure a minimally invasive surgical treatment strategy keeping the stability of the spine while removing the tumors with an satisfactory outcome.