Resectie als behandeling van spinale intramedullaire tumoren

The authors retrospectively report the results of surgical treatment of spinal cord tumours in the Department of Neurosurgery, University Hospital Utrecht, Holland and review the recent literature. Twenty-eight patients were operated on for an intramedullary spinal cord tumour between 1981 and 1990. The mean follow-up period was 31 months. Neurological evaluation was done using the grading system described by Cooper and Epstein, immediately postoperatively and after 6 months. A total or subtotal resection could be performed in 22 (79%) of the 28 patients. Postoperatively, the neurological function of the legs improved or remained stable in 21 of the 28 patients, and the function of the arms in 26 of the 28 patients. After six months the neurological function in arms and legs had improved or remained stable in 19 of 21 patients. The most frequently occurring tumour, ependymoma, could be radically resected more often (82%) than astrocytoma (33%). Postoperative morbidity is closely related to the level of involvement. Microsurgical exploration at the cervical level is far less dangerous than has always been believed. Surgical mortality was 0%. Radical resection of intramedullary tumours should be attempted and can be achieved with stabilisation or improvement of neurological deficit in the majority of patients