Indications for Fusion With Intradural Spine Tumor Resection in Adults: A Systematic Review and Meta-analysis

Quiceno, Esteban; Hussein, Amna; Pico, Annie; Abdulla, Ebtesam; Bauer, Isabel L.; Nosova, Kristin; Moniakis, Alexandros; Khan, Monis Ahmed; Farhadi, Dara S.; Prim, M.; Baaj, Ali A.

doi:10.1016/j.wneu.2023.04.041

Cited by 3 publications

(2 citation statements)

References 52 publications

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“…Factors potentially leading to instability after laminoplasties are preoperative deformities and performing facetectomies. None of these criteria were present in our cohort [19][20][21].…”

Section: Discussionmentioning

confidence: 92%

“…Fixation after the resection of intradural spinal tumors is a common practice especially if three or more segments are involved [18] even though there is evidence that it is only required if significant bony erosion or facet/ligamentous complex injuries occur. However, these scenarios are rare in intradural spinal tumor resection [19]. Factors potentially leading to instability after laminoplasties are preoperative deformities and performing facetectomies.…”

Section: Discussionmentioning

confidence: 99%

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Spinal Intradural Tumor Resection via Long-Segment Approaches and Clinical Long-Term Follow-Up

Dieringer,

Baumgart,

Schwieren

et al. 2024

Cancers

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Introduction: Spinal intradural tumors account for 15% of all CNS tumors. Typical tumor entities include ependymomas, astrocytomas, meningiomas, and neurinomas. In cases of multiple affected segments, extensive approaches may be necessary to achieve the gold standard of complete tumor resection. Methods: We performed a bicentric, retrospective cohort study of all patients equal to or older than 14 years who underwent multi-segment surgical treatment for spinal intradural tumors between 2007 and 2023 with approaches longer than four segments without instrumentation. We assessed the surgical technique and the clinical outcome regarding signs of symptomatic spinal instability. Children were excluded from our cohort. Results: In total, we analyzed 33 patients with a median age of 44 years and interquartile range IQR of 30–56 years, including the following tumors: 21 ependymomas, one subependymoma–ependymoma mixed tumor, two meningiomas, two astrocytomas, and seven patients with other entities. The median length of the approach was five spinal segments with a range of 4–14 and with the foremost localization in the cervical or thoracic spine. Laminoplasty was the most chosen approach (72.2%). The median time to follow-up was 13 months IQR (4–56 months). Comparing pre- and post-surgery outcomes, 72.2% of the patients (n = 24) reported pain improvement after surgery. The median modified McCormick scores pre- and post surgery were equal to II IQR (I–II) and II IQR (I–III), respectively. Discussion: We achieved satisfying results with long-segment approaches. In general, patients reported pain improvement after surgery and received similar low modified McCormick scores pre- and post surgery and did not undergo secondary dorsal fixation. Thus, we conclude that intradural tumor resection via extensive approaches does not seem to impair long-term spinal stability in our cohort.

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“…Factors potentially leading to instability after laminoplasties are preoperative deformities and performing facetectomies. None of these criteria were present in our cohort [19][20][21].…”

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Spinal Intradural Tumor Resection via Long-Segment Approaches and Clinical Long-Term Follow-Up

Dieringer,

Baumgart,

Schwieren

et al. 2024

Cancers

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Letter to the Editor Regarding “Indications for Fusion with Intradural Spine Tumor Resection in Adults: A Systematic Review and Meta-analysis”

Pacheco-Barrios,

Calisaya-Madariaga,

Canazas-Paredes

2023

World Neurosurgery

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Late Presentation of a Primary Spinal Epidural Non-Hodgkin Lymphoma

Niryana,

Wiyanjana,

Kusuma

et al. 2024

Neurologico Spinale Medico Chirurgico

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Primary spinal epidural lymphomas (PSELs) constitute a unique subset of epidural tumors characterized by the exclusive presence of lymphoma within the epidural space at initial presentation, with no concurrent lymphoma in other sites. We aim to present a unique of PSEL and compare it with the present literature This case report presents a 65-year-old female with delayed-onset primary spinal epidural non-Hodgkin lymphoma (NHL). The patient exhibited paraplegia and walking difficulties, following a year of lower-extremity weakness and tingling sensations. Magnetic resonance imaging revealed a mass in the L1 through L3. Surgical decompression, stabilization, and tumor resection were performed. Microscopic examination confirmed NHL. Chemotherapy with the CHOP regimen was administered postsurgery. Subsequent follow-up revealed motoric and sensory improvements. PSEL primarily affects the thoracic spine and is more common in males. Patient age and gender impact prognosis. PSEL typically exhibits two phases – prodromal and rapid neurological deterioration. Surgical intervention coupled with chemotherapy is recommended, but the optimal surgical approach varies. Combined therapy could lead to improved disease-free survival. Cases of PSEL have shown potential for local and systemic relapse. Late presentation can still yield improvements with surgical and prompt chemotherapeutic intervention. Even without a prior history of malignancy or significant disease, PSEL should still be considered in patients presenting with spinal compression symptoms. Cases of delayed presentation, like the one presented here, can still benefit from surgical and prompt chemotherapeutic intervention.

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Indications for Fusion With Intradural Spine Tumor Resection in Adults: A Systematic Review and Meta-analysis

Cited by 3 publications

References 52 publications

Spinal Intradural Tumor Resection via Long-Segment Approaches and Clinical Long-Term Follow-Up

Spinal Intradural Tumor Resection via Long-Segment Approaches and Clinical Long-Term Follow-Up

Letter to the Editor Regarding “Indications for Fusion with Intradural Spine Tumor Resection in Adults: A Systematic Review and Meta-analysis”

Late Presentation of a Primary Spinal Epidural Non-Hodgkin Lymphoma

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