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Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors

INTRODUCTION: Intramedullary spinal cord tumors (IMSCT) account for about 2%–4% of all central nervous system tumors. Surgical resection is the main treatment step, but might cause damage to functional tissues. Intraoperative neuromonitoring (IONM) is an adopted measure to decrease surgical complica...

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Autores principales: Ruschel, Leonardo Gilmone, Aragão, Afonso, de Oliveira, Matheus Fernandes, Milano, Jerônimo Buzetti, Neto, Mauricio Coelho, Ramina, Ricardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244684/
https://www.ncbi.nlm.nih.gov/pubmed/34268146
http://dx.doi.org/10.4103/ajns.AJNS_234_20
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author Ruschel, Leonardo Gilmone
Aragão, Afonso
de Oliveira, Matheus Fernandes
Milano, Jerônimo Buzetti
Neto, Mauricio Coelho
Ramina, Ricardo
author_facet Ruschel, Leonardo Gilmone
Aragão, Afonso
de Oliveira, Matheus Fernandes
Milano, Jerônimo Buzetti
Neto, Mauricio Coelho
Ramina, Ricardo
author_sort Ruschel, Leonardo Gilmone
collection PubMed
description INTRODUCTION: Intramedullary spinal cord tumors (IMSCT) account for about 2%–4% of all central nervous system tumors. Surgical resection is the main treatment step, but might cause damage to functional tissues. Intraoperative neuromonitoring (IONM) is an adopted measure to decrease surgical complications. Below, we describe the results of IMSCT submitted to surgery under IONM at a tertiary institution. METHODS: The sample consisted of consecutive patients with IMSCT admitted to the Neurological Institute of Curitiba from January 2007 to November 2016. A total of 47 patients were surgically treated. Twenty-three were male (48.9%) and 24 were female (51.1%). The mean age was 42.77 years. The mean follow-up time was 42.7 months. RESULTS: Neurological status improved in 29 patients (62%), stable in 6 (13%), and worse in 12 (25%). Patients who presented with motor symptoms at initial diagnosis had a worse outcome compared to patients with sensory impairment and pain (P = 0.026). Patients with a change in electromyography had worse neurological outcomes compared to patients who did not show changes in monitoring (P = 0.017). DISCUSSION AND CONCLUSION: No prospective randomized high evidence study has been performed to date to compare clinical evolution after surgery with or without monitoring. In our sample, surgical resection was well succeeded mainly in oligosymptomatic patients with low preoperative McCormick classification and no worsening of IONM during surgery. We believe that microsurgical resection of IMSCT with simultaneous IONM is the gold standard treatment and achieved with good results.
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spelling pubmed-82446842021-07-14 Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors Ruschel, Leonardo Gilmone Aragão, Afonso de Oliveira, Matheus Fernandes Milano, Jerônimo Buzetti Neto, Mauricio Coelho Ramina, Ricardo Asian J Neurosurg Original Article INTRODUCTION: Intramedullary spinal cord tumors (IMSCT) account for about 2%–4% of all central nervous system tumors. Surgical resection is the main treatment step, but might cause damage to functional tissues. Intraoperative neuromonitoring (IONM) is an adopted measure to decrease surgical complications. Below, we describe the results of IMSCT submitted to surgery under IONM at a tertiary institution. METHODS: The sample consisted of consecutive patients with IMSCT admitted to the Neurological Institute of Curitiba from January 2007 to November 2016. A total of 47 patients were surgically treated. Twenty-three were male (48.9%) and 24 were female (51.1%). The mean age was 42.77 years. The mean follow-up time was 42.7 months. RESULTS: Neurological status improved in 29 patients (62%), stable in 6 (13%), and worse in 12 (25%). Patients who presented with motor symptoms at initial diagnosis had a worse outcome compared to patients with sensory impairment and pain (P = 0.026). Patients with a change in electromyography had worse neurological outcomes compared to patients who did not show changes in monitoring (P = 0.017). DISCUSSION AND CONCLUSION: No prospective randomized high evidence study has been performed to date to compare clinical evolution after surgery with or without monitoring. In our sample, surgical resection was well succeeded mainly in oligosymptomatic patients with low preoperative McCormick classification and no worsening of IONM during surgery. We believe that microsurgical resection of IMSCT with simultaneous IONM is the gold standard treatment and achieved with good results. Wolters Kluwer - Medknow 2021-05-28 /pmc/articles/PMC8244684/ /pubmed/34268146 http://dx.doi.org/10.4103/ajns.AJNS_234_20 Text en Copyright: © 2021 Asian Journal of Neurosurgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Ruschel, Leonardo Gilmone
Aragão, Afonso
de Oliveira, Matheus Fernandes
Milano, Jerônimo Buzetti
Neto, Mauricio Coelho
Ramina, Ricardo
Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors
title Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors
title_full Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors
title_fullStr Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors
title_full_unstemmed Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors
title_short Correlation of Intraoperative Neurophysiological Parameters and Outcomes in Patients with Intramedullary Tumors
title_sort correlation of intraoperative neurophysiological parameters and outcomes in patients with intramedullary tumors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244684/
https://www.ncbi.nlm.nih.gov/pubmed/34268146
http://dx.doi.org/10.4103/ajns.AJNS_234_20
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