Publications

Background: Intramedullary spinal cord tumors (IMSCTs) are rare neoplasms that account for 2-5% of all spinal tumors. They can lead to significant neurological deficits due to their location within the spinal cord. IMSCTs primarily include ependymomas, astrocytomas and hemangioblastomas, with clinical outcomes highly dependent on the extent of resection and preoperative neurological status. This case series presents eight patients with rare IMSCTs, discussing the surgical management, postoperative outcomes, and the role of adjuvant therapies. 

Methods: A retrospective case series was conducted by reviewing eight cases of IMSCTs treated in a tertiary hospital over four years. Data on demographic details, clinical presentation, surgical interventions, histopathology, and postoperative outcomes were collected. Intraoperative neuromonitoring was used in some cases to minimize neurological injury during tumor resection. 

Results: Eight patients underwent surgical resection for IMSCTs, with histopathological findings ranging from subependymoma to high-grade gliomas. Gross total resection was achieved in five cases, while the remaining three underwent subtotal resection due to the diffuse nature of the tumors.Postoperatively, four patients demonstrated significant neurological improvement,while two remained stable, and two were lost to follow-up. Four patients required adjuvant radiotherapy due to high-grade tumors. 

Conclusion: Surgical resection remains the mainstay of treatment for IMSCTs, with gross total resection offering the best prognosis, especially for low-grade tumors.In high-grade cases, adjuvant therapies are essential due to the high potential for recurrence. Early diagnosis and intervention, coupled with intraoperative neuromonitoring, are crucial for optimizing neurological outcomes. 

Keywords: Intramedullary Spinal Cord Tumors, Ependymoma, Astrocytoma, Surgical Resection, Glioma