Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Dec;44(6):3267-3275.
doi: 10.1007/s10143-021-01491-8. Epub 2021 Feb 9.

Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications-a multicenter study

Roberto Gazzeri  1   2 , Stefano Telera  3 , Marcelo Galarza  4 , Giorgio Maria Callovini  5 , Sperduti Isabella  6 , Alex Alfieri  7   8
Affiliations
Multicenter Study

Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications-a multicenter study

Roberto Gazzeri et al. Neurosurg Rev. 2021 Dec.

Abstract

Intramedullary spinal cord metastasis (ISCM) is a rare event in the course of advanced malignancy. Management of these lesions remains controversial. Recently, surgery for ISCM has been advocated for selected patients. We performed a retrospective analysis of the clinical course, complications, and outcome of 30 patients surgically treated for ISCM. Patients' age, histopathological diagnoses of primary cancer, tumor size, spinal location, and extramedullary tumor dissemination were collected. Preoperative functional status, pre- and postoperative neurological status, and extent of the tumor resection were also analyzed. Predominant tumor location was thoracic, followed by cervical and conus medullaris. Lung cancer constituted the majority of primary malignancies. In 9 cases, one of the indications for spinal surgery was to obtain a histopathological diagnosis. On admission, all patients presented with neurological symptoms suggestive of myelopathy. After surgery, 18 patients exhibited improvement of symptoms in terms of pain relief and partial recovery of motor and/or sensory deficits; 6 patients were unchanged, while 6 patients exhibited postoperative deterioration. Median survival time after surgery was 9.9 months. Age > 70 years old, presence of systemic metastases, preoperative neurological non functional status, and lung cancer as primary tumor were all factors associated with a worse survival prognosis. This study did not show a clear survival difference between gross total and subtotal ISCM tumor resection. Patients who underwent gross total resection had a worse functional outcome with respect to patients with only partial resection. Gross total resection with low morbidity must be the surgical target, but when not possible, subtotal resection and adjuvant therapy are a valid therapeutic option.

Keywords: Intramedullary metastases; Intramedullary spinal cord tumor; Metastases; Spinal cord metastases; Spinal cord tumor; Spine surgery.

PubMed Disclaimer

References

    1. Bagley CA, Gokaslan ZL (2004) Cauda equina syndrome causedby primary and metastatic neoplasm. Neurosur Focus 16(6):e3 - DOI
    1. Callovini GM, Bolognini A, Giordano M, Gazzeri R (2017) Surgical considerations for intramedullary conus medullaris metastatic tumors with origin from primary lung lesions: a review of the literature. Neurol India 65(1):211–214 - PubMed
    1. Connolly ES Jr, Winfree CJ, McCormick PC, Cruz M, Stein BM (1996) Intramedullary spinal cord metastasis: report of three cases and review of the literature. Surg Neurol 46:329–337 - DOI
    1. Costigan D, Winkelman MD (1985) Intramedullary spinal cord metastasis. A clinicopathological study of 13 cases. J Neurosurg 62:227–233 - DOI
    1. Dam-Hieu P, Seizeura R, Mineoa F, Metgesb JP, Meriot P, Simonb H (2009) Retrospective study of 19 patients with intramedullary spinal cord metastasis. Clin Neurol Neurosurg 111(1):10–17 - DOI

Publication types

LinkOut - more resources