Surgery for spinal intramedullary tumors: technique, outcome and factors affecting resectability

Sherif Rashad, Amr Elwany, Ahmed Farhoud

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Intramedullary spinal cord tumors (IMSCTs) are relatively infrequent lesions with ependymomas and astrocytomas representing the most common types. Microsurgical resection is established as the treatment of choice for these challenging lesions. We reviewed the surgical outcome of 29 cases operated for IMSCTs by the same surgeon between 2009 and 2015. The median follow-up period was 31 months, and all patients were followed up at least for 1 year. Among these 29 cases, 5 patients were previously operated for partial resection elsewhere. Age ranged from 9 to 62 years with a median of 39 years. All patients were symptomatic before surgery. The most common pathology was ependymoma (16 cases), and the most common tumor location was the cervical spine (18 cases). Gross total resection was achieved in 20 out of 29 cases (68.9%). Tumors were totally excised in all cases of ependymoma except in two patients; one was previously operated and irradiated and the second had an extensive anaplastic ependymoma. Sixteen cases experienced immediate post-operative worsening which was temporary in all but one case. At 1-year follow up, 23 patients (79.3%) maintained their pre-operative McCormick grade, 5 patients (17.2%) had a better grade, and 1 patient (3.5%) deteriorated. Surgery still represents the mainstay in the management of IMSCT. Gross total resection can be achieved safely in many cases especially in the presence of an identifiable plane of cleavage between the tumor and the normal spinal cord.

Original languageEnglish
Pages (from-to)503-511
Number of pages9
JournalNeurosurgical Review
Issue number2
Publication statusPublished - 2018 Apr 1
Externally publishedYes


  • Intramedullary
  • Outcome
  • Spinal tumor
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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