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Prognostic Factors of Surgery for Cervical Cord Tumors

• 2014
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Publication Information
Authors Mahmoud Wahdan, Fathi El-Noss, Hossam Maaty,Waleed Badawy and Alaa Farag
Keywords Not Available
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publication.type Local
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Abstract
Background: Spinal cord tumors represent 10% to 15% of central nervous system (CNS)
neoplasms. In adults, two thirds of these tumors are extramedullary and the remaining
third are intramedullary. Objective: We aimed to outline the prognostic factors that
affect the final outcome of cervical cord tumor surgeries. Patients and Methods: Sixty
one patients with cervical spinal cord tumors underwent surgery between march 2009
and march 2014. The neurological status before surgery, 1 month after the operation
and at the most recent examination were assessed based on the grading system of
McCormick outcome. The 61 patients, divided according to the histopathological
diagnosis. Results: There were 22 ependymoma (36.1%), 13 Scwannoma (21.3%), 12
Meningioma (19.7%), 6 Neurofibroma (9.8%), 3 Astrocytoma (4.9%) and 5 other
pathologies collectively (8.2%). In this study there was 75% of patients with total
resection, 11.4% had subtotal and 13.1% had partial resection or biopsy. Thirty seven
patients was improved (60.7%), thirteen patients with no change (21.3%), ten patients
deteriorated (16.4%) and one died (1.6%). By statistical analysis, there was significant
correlation between postoperative outcome and the tumor grade (P=0.015), the less the
grade the better outcome .We found a significant correlation between the pre-operative
state and the final functional outcome, that, the better the preoperative state the better
outcome. There is statistically relevant correlation between the recurrence and the
degree of resection. Conclusion: The spinal cord tumors can be treated safely and
effectively by surgery. Total resection must be the essential aim before surgery.
Preoperative neurological state, pathological type, pathological grades, and degree of
resection are the most important factors that affect the final outcome.