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Posterolateral myelotomy for intramedullary spinal cord tumors: the other way to do it?

  • Original Article - Spine - Other
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Abstract

Background and purpose

To evaluate posterolateral myelotomy (PLM) as a surgical method for all cases of intramedullary spinal cord tumors (IMSCT) by assessing the surgical and functional outcomes of patients treated in our clinic.

Materials and methods

Patients with IMSCT who underwent surgery using PLM from 2013 to 2018 were reviewed retrospectively. Objective and quantitative assessment of the preoperative, postoperative, and follow-up neurological status was performed by using the modified McCormick functional schema and sensory pain scale.

Results

A total of 33 operations were performed on 27 patients who met the inclusion criteria. The mean grade on the McCormick functional schema increased insignificantly from 2.0 preoperatively to 2.3 immediately postoperatively and decreased back to 2.1 at the follow-up examination. Just one patient exhibited a transient proprioception deficit. Significant pain relief was observed as expressed in an improvement of mean grade on the sensory pain scale. Only in two cases was late neuropathic pain reported. A gross total resection/subtotal resection (GTR/STR) was achieved in all cases of hemangioblastoma and cavernoma, while for the majority of astrocytomas, only partial removal was accomplished. For ependymoma, which represents the most common IMSCT, a GTR/STR was realized in 12 cases (86%). A statistically significant difference (p = 0.027) was found when comparing the extent of tumor resection (EOR) between the two most common IMSCT, i.e., ependymoma and astrocytoma.

Conclusion

PLM may be considered a reliable surgical method for IMSCT, as it combines a satisfactory EOR with reduced risk of tissue damage and excellent pain relief.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Bochum, In der Schornau Str. 23-25, 44892, Bochum, Germany

    Sotirios Katsigiannis, Anne Elisabeth Carolus, Kirsten Schmieder & Christopher Brenke

Authors
  1. Sotirios Katsigiannis
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  2. Anne Elisabeth Carolus
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  3. Kirsten Schmieder
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  4. Christopher Brenke
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Contributions

Conception and design: SK and CB. Acquisition of medical data of the patients: SK and CB. Data analysis and interpretation: SK. Manuscript writing: SK. Revision of the manuscript: AEC, CS, and CB. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sotirios Katsigiannis.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Katsigiannis, S., Carolus, A.E., Schmieder, K. et al. Posterolateral myelotomy for intramedullary spinal cord tumors: the other way to do it?. Acta Neurochir 162, 101–107 (2020). https://doi.org/10.1007/s00701-019-04151-5

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  • DOI: https://doi.org/10.1007/s00701-019-04151-5

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