Neurológia pre prax 4/2009

Current principles of surgical treatment of spinal and spinal cord tumours

The spinal cord and the spinal cord roots may be affected by tumours that arise primarily from the spinal cord (intramedullary tumours), the spinal cord roots and the meninges (intradural extramedullary tumours), or from the osseous, cartilaginous and fibrous structures of the spine (extradural tumours). Metastatic tumours are extremely rarely located intradurally; in the extradural structures, however, they are the most common tumours. Hence, the majority of extradural tumours are malignant whereas intradural tumours are most typically benign. The goal of surgical treatment of spinal and spinal cord tumours is the removal of tumorous tissue and decompression of the neural structures in order to avoid any profound neurological deficit while preserving or improving spinal biomechanics. Permanent postoperative neurological deterioration can be prevented by means of an adequate operating technique and intraoperative neurophysiological monitoring. Spinal stability may sometimes need to be supported by implants and fixation devices. In benign tumours, the prognosis depends on the adequacy of the surgical procedure, in malignant ones primarily on their sensitivity to adjuvant oncological treatment.

Keywords: spinal cord tumours, spinal tumours, surgical treatment.