Surgical management and outcome of intramedullary spinal cord tumour.

Objective: Our aim is to assess the surgical management of intramedullary spinal cord tumours (IMSCTs) and evaluate factors associated with surgical outcomes in our hospitals. Patient and methods: Between June 2013 and June 2016, a retrospective study was conducted on 16 consecutive cases of IMSCTs. All patients provided their signed consent, and MRI was performed. The patients were surgically treated and were evaluated pre- and post-operatively by the modified McCormick scale (MMS). Appropriate statistical analysis was conducted. Results: The mean patient age was 50.4 years, and the median follow-up was 15 months. The most common histological origin was ependymoma (n = 9, 56.25%). A cervical tumour was detected in eight patients, and a dorsal tumour was detected in seven. Post-operatively, the score was clinically but not statistically improved in seven cervical (87.5%) and four dorsal (57.1%) tumours (p = 0.334). Ten patients underwent total resection. Post-operative MMS scores showed improvement in all cases of total resection (n = 10, 100%). This improvement was clinically and statistically significant on last follow-up (p = 0.008). Fewer than four segments were involved in 9 cases, and more than four segments were involved in 7 cases. Post-operatively, all 9 patients (100%) with fewer than four involved segments improved, while only three patients (42.9%) with more than 4 involved segments improved (p = 0.019). Low-grade tumours such as ependymomas were correlated with good surgical outcomes, while high-grade tumours such as astrocytomas were correlated with poor surgical outcomes (p = 0.022). Conclusions: Total tumour resection coupled with good preoperative clinical condition for tumours localised in the cervical or conus region predicts good neurological outcomes. Tumour localisation in the dorsal region with multi-segmental extension and high-grade tumour pathology predicts poor neurological outcomes. [ABSTRACT FROM AUTHOR]