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Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas

STUDY DESIGN: A retrospective study. PURPOSE: We report our experience with 5-aminolevulinic acid (5-ALA)–assisted resection of spinal cord ependymomas in adults. OVERVIEW OF LITERATURE: Ependymoma is the most frequent primary spinal cord tumor in adults. Surgery is the treatment of choice in most c...

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Autores principales: Moreno, Rafael García, García, Luis Miguel Bernal, Bastidas, Hyaissa Ippolito, Tirado, Carlos Andrés Mondragón, Flores, Aurora Moreno, Cabezas, Juan Pablo Sosa, Artero, José Manuel Cabezudo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365784/
https://www.ncbi.nlm.nih.gov/pubmed/30347527
http://dx.doi.org/10.31616/asj.2018.0165
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author Moreno, Rafael García
García, Luis Miguel Bernal
Bastidas, Hyaissa Ippolito
Tirado, Carlos Andrés Mondragón
Flores, Aurora Moreno
Cabezas, Juan Pablo Sosa
Artero, José Manuel Cabezudo
author_facet Moreno, Rafael García
García, Luis Miguel Bernal
Bastidas, Hyaissa Ippolito
Tirado, Carlos Andrés Mondragón
Flores, Aurora Moreno
Cabezas, Juan Pablo Sosa
Artero, José Manuel Cabezudo
author_sort Moreno, Rafael García
collection PubMed
description STUDY DESIGN: A retrospective study. PURPOSE: We report our experience with 5-aminolevulinic acid (5-ALA)–assisted resection of spinal cord ependymomas in adults. OVERVIEW OF LITERATURE: Ependymoma is the most frequent primary spinal cord tumor in adults. Surgery is the treatment of choice in most cases. However, while complete resection is achieved in approximately 80% of cases, clinical improvement is achieved in 15% only. Five-ALA fluorescence–guided surgery seems to be useful for this tumor type. METHODS: We studied 14 patients undergoing 5-ALA fluorescence-guided surgery for spinal cord ependymomas in our service. The modified McCormick classification was used to determine clinical status and the degree of resection was assessed with magnetic resonance imaging. RESULTS: Of the 14 patients, the tumor showed an intense emission of fluorescence in 12 and the fluorescence was weak and nonuniform in two. Complete resection was achieved in 11 cases. According to the McCormick classification, 10 patients improved, two remained the same, and two deteriorated. CONCLUSIONS: Our results confirm that 5-ALA fluorescence-guided resection is useful in spinal cord ependymoma resection. Although the rate of complete resections is similar to that in published series without 5-ALA, clinical results are better when using 5-ALA with a lower percentage of clinical deterioration.
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spelling pubmed-63657842019-02-08 Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas Moreno, Rafael García García, Luis Miguel Bernal Bastidas, Hyaissa Ippolito Tirado, Carlos Andrés Mondragón Flores, Aurora Moreno Cabezas, Juan Pablo Sosa Artero, José Manuel Cabezudo Asian Spine J Clinical Study STUDY DESIGN: A retrospective study. PURPOSE: We report our experience with 5-aminolevulinic acid (5-ALA)–assisted resection of spinal cord ependymomas in adults. OVERVIEW OF LITERATURE: Ependymoma is the most frequent primary spinal cord tumor in adults. Surgery is the treatment of choice in most cases. However, while complete resection is achieved in approximately 80% of cases, clinical improvement is achieved in 15% only. Five-ALA fluorescence–guided surgery seems to be useful for this tumor type. METHODS: We studied 14 patients undergoing 5-ALA fluorescence-guided surgery for spinal cord ependymomas in our service. The modified McCormick classification was used to determine clinical status and the degree of resection was assessed with magnetic resonance imaging. RESULTS: Of the 14 patients, the tumor showed an intense emission of fluorescence in 12 and the fluorescence was weak and nonuniform in two. Complete resection was achieved in 11 cases. According to the McCormick classification, 10 patients improved, two remained the same, and two deteriorated. CONCLUSIONS: Our results confirm that 5-ALA fluorescence-guided resection is useful in spinal cord ependymoma resection. Although the rate of complete resections is similar to that in published series without 5-ALA, clinical results are better when using 5-ALA with a lower percentage of clinical deterioration. Korean Society of Spine Surgery 2019-02 2018-10-24 /pmc/articles/PMC6365784/ /pubmed/30347527 http://dx.doi.org/10.31616/asj.2018.0165 Text en Copyright © 2019 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Moreno, Rafael García
García, Luis Miguel Bernal
Bastidas, Hyaissa Ippolito
Tirado, Carlos Andrés Mondragón
Flores, Aurora Moreno
Cabezas, Juan Pablo Sosa
Artero, José Manuel Cabezudo
Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
title Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
title_full Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
title_fullStr Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
title_full_unstemmed Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
title_short Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas
title_sort fluorescence guided surgery with 5-aminolevulinic acid for resection of spinal cord ependymomas
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365784/
https://www.ncbi.nlm.nih.gov/pubmed/30347527
http://dx.doi.org/10.31616/asj.2018.0165
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