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Intramedullary Spinal Cord Tumors

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Brain and Spine Surgery in the Elderly

Abstract

As health care quality continues to improve and reach new limits, neurosurgeons are increasingly confronted with management dilemmas for disorders in the geriatric population. Some physicians hesitate to recommend surgery for elderly patients (>65 years), arguing that older age harbors higher surgical risk and may lead to functional compromise, therefore deferring to conservative treatment measures. However, throughout the years, reports have suggested that in elderly patients, good functional outcomes after surgery can result when patients are carefully selected and that age alone should not preclude surgical candidacy [2, 59].

Funding disclosure for this work: None.

Source of financial support and industry affiliations:

Rajiv R. Iyer, MD: None.

George I. Jallo, MD: None.

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References

  1. Aghayev K, Vrionis F, Chamberlain MC (2011) Adult intradural primary spinal cord tumors. J Natl Compr Canc Netw 9:434–447

    Article  PubMed  Google Scholar 

  2. Amelot A, Balabaud L, Choi D, Fox Z, Crockard HA, Albert T, Arts CM, Buchowski JM, Bunger C, Chung CK, Coppes MH, Depreitere B, Fehlings MG, Harrop J, Kawahara N, Kim ES, Lee CS, Leung Y, Liu ZJ, Martin-Benlloch JA, Massicotte EM, Meyer B, Oner FC, Peul W, Quraishi N, Tokuhashi Y, Tomita K, Ulbricht C, Verlaan JJ, Wang M, Mazel C (2015) Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery!. Spine J:S1529–9430(15). PMID: 26239762

    Google Scholar 

  3. Asthagiri AR, Parry DM, Butman JA, Kim HJ, Tsilou ET, Zhuang Z, Lonser RR (2009) Neurofibromatosis type 2. Lancet 373:1974–1986

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Avila MJ, Walter CM, Skoch J, Abbasifard S, Patel AS, Sattarov K, Baaj AA (2015) Fusion after intradural spine tumor resection in adults: a review of evidence and practices. Clin Neurol Neurosurg 138:169–173

    Article  PubMed  Google Scholar 

  5. Barnwell SL, Dowd CF, Davis RL, Edwards MS, Gutin PH, Wilson CB (1990) Cryptic vascular malformations of the spinal cord: diagnosis by magnetic resonance imaging and outcome of surgery. J Neurosurg 72:403–407

    Article  CAS  PubMed  Google Scholar 

  6. Bourgouin PM, Lesage J, Fontaine S, Konan A, Roy D, Bard C, Del Carpio O'Donovan R (1998) A pattern approach to the differential diagnosis of intramedullary spinal cord lesions on MR imaging. AJR Am J Roentgenol 170:1645–1649

    Article  CAS  PubMed  Google Scholar 

  7. Brotchi J (2002) Intrinsic spinal cord tumor resection. Neurosurgery 50:1059–1063

    PubMed  Google Scholar 

  8. Brotchi J, Fischer G (1998) Spinal cord ependymomas. Neurosurg Focus 4:e2

    Article  CAS  PubMed  Google Scholar 

  9. Bull FE, Dodge HW Jr, Hanlon DG, Sickert RC (1956) Tumor of the spinal cord; occurrence in patients with pernicious anemia and subacute combined sclerosis. J Am Med Assoc 162:707–709

    Article  CAS  PubMed  Google Scholar 

  10. Cohen-Gadol AA, Jacob JT, Edwards DA, Krauss WE (2006) Coexistence of intracranial and spinal cavernous malformations: a study of prevalence and natural history. J Neurosurg 104:376–381

    Article  PubMed  Google Scholar 

  11. Conway JE, Chou D, Clatterbuck RE, Brem H, Long DM, Rigamonti D (2001) Hemangioblastomas of the central nervous system in von Hippel-Lindau syndrome and sporadic disease. Neurosurgery 48:55–62; discussion 62–53

    CAS  PubMed  Google Scholar 

  12. Cooper PR (1989) Outcome after operative treatment of intramedullary spinal cord tumors in adults: intermediate and long-term results in 51 patients. Neurosurgery 25:855–859

    Article  CAS  PubMed  Google Scholar 

  13. Cooper PR, Epstein F (1985) Radical resection of intramedullary spinal cord tumors in adults. Recent experience in 29 patients. J Neurosurg 63:492–499

    Article  CAS  PubMed  Google Scholar 

  14. Dang L, Liu X, Dang G, Jiang L, Wei F, Yu M, Wu F, Liu Z (2015) Primary tumors of the spine: a review of clinical features in 438 patients. J Neurooncol 121:513–520

    Article  PubMed  Google Scholar 

  15. de Jonge T, Slullitel H, Dubousset J, Miladi L, Wicart P, Illes T (2005) Late-onset spinal deformities in children treated by laminectomy and radiation therapy for malignant tumours. Eur Spine J 14:765–771

    Article  PubMed  PubMed Central  Google Scholar 

  16. Deiner S, Silverstein JH (2011) Anesthesia for geriatric patients. Minerva Anestesiol 77:180–189

    CAS  PubMed  Google Scholar 

  17. Deletis V, Sala F (2008) Intraoperative neurophysiological monitoring of the spinal cord during spinal cord and spine surgery: a review focus on the corticospinal tracts. Clin Neurophysiol 119:248–264

    Article  PubMed  Google Scholar 

  18. Deng X, Wang K, Wu L, Yang C, Yang T, Zhao L, Yang J, Wang G, Fang J, Xu Y (2014) Intraspinal hemangioblastomas: analysis of 92 cases in a single institution: clinical article. J Neurosurg Spine 21:260–269

    Article  PubMed  Google Scholar 

  19. Deutsch H, Jallo GI, Faktorovich A, Epstein F (2000) Spinal intramedullary cavernoma: clinical presentation and surgical outcome. J Neurosurg 93:65–70

    CAS  PubMed  Google Scholar 

  20. Duong LM, McCarthy BJ, McLendon RE, Dolecek TA, Kruchko C, Douglas LL, Ajani UA (2012) Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004–2007. Cancer 118:4220–4227

    Article  PubMed  PubMed Central  Google Scholar 

  21. Epstein FJ, Farmer JP, Freed D (1992) Adult intramedullary astrocytomas of the spinal cord. J Neurosurg 77:355–359

    Article  CAS  PubMed  Google Scholar 

  22. Epstein FJ, Farmer JP, Freed D (1993) Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients. J Neurosurg 79:204–209

    Article  CAS  PubMed  Google Scholar 

  23. Epstein FJ, Farmer JP, Schneider SJ (1991) Intraoperative ultrasonography: an important surgical adjunct for intramedullary tumors. J Neurosurg 74:729–733

    Article  CAS  PubMed  Google Scholar 

  24. Garcia PS, Duggan EW, McCullough IL, Lee SC, Fishman D (2015) Postanesthesia care for the elderly patient. Clin Ther 37:2651–2665

    Article  PubMed  Google Scholar 

  25. Grimm S, Chamberlain MC (2009) Adult primary spinal cord tumors. Expert Rev Neurother 9:1487–1495

    Article  PubMed  Google Scholar 

  26. Guidetti B, Mercuri S, Vagnozzi R (1981) Long-term results of the surgical treatment of 129 intramedullary spinal gliomas. J Neurosurg 54:323–330

    Article  CAS  PubMed  Google Scholar 

  27. Hanbali F, Fourney DR, Marmor E, Suki D, Rhines LD, Weinberg JS, McCutcheon IE, Suk I, Gokaslan ZL (2002) Spinal cord ependymoma: radical surgical resection and outcome. Neurosurgery 51:1162–1172; discussion 1172–1164

    Article  PubMed  Google Scholar 

  28. Helseth A, Mork SJ (1989) Primary intraspinal neoplasms in Norway, 1955 to 1986. A population-based survey of 467 patients. J Neurosurg 71:842–845

    Article  CAS  PubMed  Google Scholar 

  29. Hoshimaru M, Koyama T, Hashimoto N, Kikuchi H (1999) Results of microsurgical treatment for intramedullary spinal cord ependymomas: analysis of 36 cases. Neurosurgery 44:264–269

    Article  CAS  PubMed  Google Scholar 

  30. Houten JK, Cooper PR (2000) Spinal cord astrocytomas: presentation, management and outcome. J Neurooncol 47:219–224

    Article  CAS  PubMed  Google Scholar 

  31. Jallo GI, Danish S, Velasquez L, Epstein F (2001) Intramedullary low-grade astrocytomas: long-term outcome following radical surgery. J Neurooncol 53:61–66

    Article  CAS  PubMed  Google Scholar 

  32. Jallo GI, Freed D, Epstein F (2003) Intramedullary spinal cord tumors in children. Childs Nerv Syst 19:641–649

    Article  PubMed  Google Scholar 

  33. Jallo GI, Freed D, Zareck M, Epstein F, Kothbauer KF (2006) Clinical presentation and optimal management for intramedullary cavernous malformations. Neurosurg Focus 21:e10

    Article  PubMed  Google Scholar 

  34. Jallo GI, Kothbauer KF, Epstein FJ (2001) Intrinsic spinal cord tumor resection. Neurosurgery 49:1124–1128

    CAS  PubMed  Google Scholar 

  35. Khodadad G (1973) Common errors in the diagnosis of spinal meningiomas. Geriatrics 28:143–145

    CAS  PubMed  Google Scholar 

  36. Linstadt DE, Wara WM, Leibel SA, Gutin PH, Wilson CB, Sheline GE (1989) Postoperative radiotherapy of primary spinal cord tumors. Int J Radiat Oncol Biol Phys 16:1397–1403

    Article  CAS  PubMed  Google Scholar 

  37. Liu A, Sankey EW, Bettegowda C, Burger PC, Jallo GI, Groves ML (2015) Poor prognosis despite aggressive treatment in adults with intramedullary spinal cord glioblastoma. J Clin Neurosci 22:1628–1631

    Article  PubMed  Google Scholar 

  38. Lonser RR (2014) Surgical management of sporadic spinal cord hemangioblastomas. World Neurosurg 82:632–633

    Article  PubMed  Google Scholar 

  39. Lonser RR, Weil RJ, Wanebo JE, DeVroom HL, Oldfield EH (2003) Surgical management of spinal cord hemangioblastomas in patients with von Hippel-Lindau disease. J Neurosurg 98:106–116

    Article  PubMed  Google Scholar 

  40. Lu DC, Lawton MT (2010) Clinical presentation and surgical management of intramedullary spinal cord cavernous malformations. Neurosurg Focus 29:E12

    Article  PubMed  Google Scholar 

  41. Mandigo CE, Ogden AT, Angevine PD, McCormick PC (2009) Operative management of spinal hemangioblastoma. Neurosurgery 65:1166–1177

    Article  PubMed  Google Scholar 

  42. Martuza RL, Eldridge R (1988) Neurofibromatosis 2 (bilateral acoustic neurofibromatosis). N Engl J Med 318:684–688

    Article  CAS  PubMed  Google Scholar 

  43. McCormick PC, Torres R, Post KD, Stein BM (1990) Intramedullary ependymoma of the spinal cord. J Neurosurg 72:523–532

    Article  CAS  PubMed  Google Scholar 

  44. McGirt MJ, Garces-Ambrossi GL, Parker SL, Sciubba DM, Bydon A, Wolinksy JP, Gokaslan ZL, Jallo G, Witham TF (2010) Short-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 238 patients. Neurosurgery 66:1005–1012

    Article  PubMed  Google Scholar 

  45. Mehta GU, Asthagiri AR, Bakhtian KD, Auh S, Oldfield EH, Lonser RR (2010) Functional outcome after resection of spinal cord hemangioblastomas associated with von Hippel-Lindau disease. J Neurosurg Spine 12:233–242

    Article  PubMed  Google Scholar 

  46. Miller DJ, McCutcheon IE (2000) Hemangioblastomas and other uncommon intramedullary tumors. J Neurooncol 47:253–270

    Article  CAS  PubMed  Google Scholar 

  47. Montano N, Trevisi G, Cioni B, Lucantoni C, Della Pepa GM, Meglio M, Papacci F (2014) The role of laminoplasty in preventing spinal deformity in adult patients submitted to resection of an intradural spinal tumor. Case series and literature review. Clin Neurol Neurosurg 125:69–74

    Article  PubMed  Google Scholar 

  48. Morota N, Deletis V, Constantini S, Kofler M, Cohen H, Epstein FJ (1997) The role of motor evoked potentials during surgery for intramedullary spinal cord tumors. Neurosurgery 41:1327–1336

    Article  CAS  PubMed  Google Scholar 

  49. Papagelopoulos PJ, Peterson HA, Ebersold MJ, Emmanuel PR, Choudhury SN, Quast LM (1997) Spinal column deformity and instability after lumbar or thoracolumbar laminectomy for intraspinal tumors in children and young adults. Spine (Phila Pa 1976) 22:442–451

    Article  CAS  Google Scholar 

  50. Parizel PM, Baleriaux D, Rodesch G, Segebarth C, Lalmand B, Christophe C, Lemort M, Haesendonck P, Niendorf HP, Flament-Durand J et al (1989) Gd-DTPA-enhanced MR imaging of spinal tumors. AJR Am J Roentgenol 152:1087–1096

    Article  CAS  PubMed  Google Scholar 

  51. Patton HD, Amassian VE (1954) Single and multiple-unit analysis of cortical stage of pyramidal tract activation. J Neurophysiol 17:345–363

    CAS  PubMed  Google Scholar 

  52. Raco A, Esposito V, Lenzi J, Piccirilli M, Delfini R, Cantore G (2005) Long-term follow-up of intramedullary spinal cord tumors: a series of 202 cases. Neurosurgery 56:972–981; discussion 972–981

    PubMed  Google Scholar 

  53. Rigamonti D, Hadley MN, Drayer BP, Johnson PC, Hoenig-Rigamonti K, Knight JT, Spetzler RF (1988) Cerebral cavernous malformations. Incidence and familial occurrence. N Engl J Med 319:343–347

    Article  CAS  PubMed  Google Scholar 

  54. Ruda R, Gilbert M, Soffietti R (2008) Ependymomas of the adult: molecular biology and treatment. Curr Opin Neurol 21:754–761

    Article  PubMed  Google Scholar 

  55. Samartzis D, Gillis CC, Shih P, O'Toole JE, Fessler RG (2015) Intramedullary spinal cord tumors: part I-epidemiology, pathophysiology, and diagnosis. Global Spine J 5:425–435

    Article  PubMed  PubMed Central  Google Scholar 

  56. Samii M, Klekamp J (1994) Surgical results of 100 intramedullary tumors in relation to accompanying syringomyelia. Neurosurgery 35:865–873; discussion 873

    Article  CAS  PubMed  Google Scholar 

  57. Sandler HM, Papadopoulos SM, Thornton AF Jr, Ross DA (1992) Spinal cord astrocytomas: results of therapy. Neurosurgery 30:490–493

    CAS  PubMed  Google Scholar 

  58. Schellinger KA, Propp JM, Villano JL, McCarthy BJ (2008) Descriptive epidemiology of primary spinal cord tumors. J Neurooncol 87:173–179

    Article  PubMed  Google Scholar 

  59. Schul DB, Wolf S, Krammer MJ, Landscheidt JF, Tomasino A, Lumenta CB (2012) Meningioma surgery in the elderly: outcome and validation of 2 proposed grading score systems. Neurosurgery 70:555–565

    Article  PubMed  Google Scholar 

  60. Sciubba DM, Chaichana KL, Woodworth GF, McGirt MJ, Gokaslan ZL, Jallo GI (2008) Factors associated with cervical instability requiring fusion after cervical laminectomy for intradural tumor resection. J Neurosurg Spine 8:413–419

    Article  PubMed  Google Scholar 

  61. Shrivastava RK, Epstein FJ, Perin NI, Post KD, Jallo GI (2005) Intramedullary spinal cord tumors in patients older than 50 years of age: management and outcome analysis. J Neurosurg Spine 2:249–255

    Article  PubMed  Google Scholar 

  62. Silver ML, Hennigar G (1952) Cerebellar hemangioma (hemangioblastoma); a clinicopathological review of 40 cases. J Neurosurg 9:484–494

    Article  CAS  PubMed  Google Scholar 

  63. Sun HI, Ozduman K, Usseli MI, Ozgen S, Pamir MN (2014) Sporadic spinal hemangioblastomas can be effectively treated by microsurgery alone. World Neurosurg 82:836–847

    Article  PubMed  Google Scholar 

  64. Vishteh AG, Sankhla S, Anson JA, Zabramski JM, Spetzler RF (1997) Surgical resection of intramedullary spinal cord cavernous malformations: delayed complications, long-term outcomes, and association with cryptic venous malformations. Neurosurgery 41:1094–1100; discussion 1100–1091

    Article  CAS  PubMed  Google Scholar 

  65. Wizigmann-Voos S, Breier G, Risau W, Plate KH (1995) Up-regulation of vascular endothelial growth factor and its receptors in von Hippel-Lindau disease-associated and sporadic hemangioblastomas. Cancer Res 55:1358–1364

    CAS  PubMed  Google Scholar 

  66. Yao KC, McGirt MJ, Chaichana KL, Constantini S, Jallo GI (2007) Risk factors for progressive spinal deformity following resection of intramedullary spinal cord tumors in children: an analysis of 161 consecutive cases. J Neurosurg 107:463–468

    PubMed  Google Scholar 

  67. Yeh JS, Sgouros S, Walsh AR, Hockley AD (2001) Spinal sagittal malalignment following surgery for primary intramedullary tumours in children. Pediatr Neurosurg 35:318–324

    Article  CAS  PubMed  Google Scholar 

  68. Zabramski JM, Wascher TM, Spetzler RF, Johnson B, Golfinos J, Drayer BP, Brown B, Rigamonti D, Brown G (1994) The natural history of familial cavernous malformations: results of an ongoing study. J Neurosurg 80:422–432

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Johns Hopkins All Children’s Hospital, Baltimore, USA

    Rajiv R. Iyer MD

  2. Institute for Brain Protections Sciences, Johns Hopkins All Children’s Hospital, 601 5th Street South, Suite 511, St. Petersburg, FL, 33701, USA

    George I. Jallo MD

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Correspondence to George I. Jallo MD .

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  1. Department of Neurosurgery, University Hospital of Lyon, Lyon, France

    Moncef Berhouma

  2. Hôpital des Charpennes, Hospices civils de Lyon, Villeurbanne, France

    Pierre Krolak-Salmon

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Iyer, R.R., Jallo, G.I. (2017). Intramedullary Spinal Cord Tumors. In: Berhouma, M., Krolak-Salmon, P. (eds) Brain and Spine Surgery in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-319-40232-1_16

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