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Outcome of Operative Intervention in Intramedullary Spinal Cord Tumours

Abstract Objective: The authors analysed the outcome of intramedullary spinal cord tumour surgery, focusing on the preoperative & postoperative neurological status and influence of preoperative gait status on postoperative gait. Methods: Retrospective analysis of medical records of 53 intramedullary tumour patients, operated at our institute between Jan 2006 and July 2012 was done. Pre - and postoperative neurological status was determined. Preoperative MRI was done. Ambulatory status were evaluated using the modified McCormick Scale. All the patients were operated using standard microsurgical techniques. Extent of resection was quantified by direct visualization with microscope as: gross resection, subtotal resection, partial resection, and biopsy. Results: 73.5% of the patients were in 40-60 years of age group (age range, 5-81 years; mean age 41 years). Region most commonly affected was thoracic (40%). The preoperative McCormick grade was I in 20 (37.7%), II in 16 (30.1%), III in 7 (13.2%), IV in 9 (16.9%), and V in 1 (1.88%) patients. Gross resection was possible in 54.7% of cases. Gross resection rate was significantly higher in good preoperative gait (grade - I). Histologically 41.5% of the lesions were ependymomas. Overall postoperative neurological status improved in 16 (30.3%) of the patients, remained unchanged in 27 (50.9%) of cases, and deteriorated in 10 (18.8%) patients. Conclusions: Better final outcome of walking ability correlated with good preoperative gait. Higher Gross resection rate was found in cases at an early stage. We favor early and optimal resection of tumour to give least morbidity and better quality of life.