![]() Follow-up MRI’s at 3-6 month intervals are indicated after surgery. Other post-op concerns are poor wound healing and cerebrospinal fluid leak. Immediately post-op, almost all patients experience some temporary sensory loss due to the requirement to split the fibers of the posterior spinal cord to achieve exposure of the tumor. Preservation rather than restoration of function is the goal, as significant improvement in neurologic function occurs rarely after longstanding advanced pre-operative deficits. Early diagnosis leads to an earlier and more aggressive surgery, with improved outcomes. Benign lesions (other than astrocytomas) can often be completely resected when a reasonable plane separates the tumor from the spinal cord tissue these include hemangioblastomas, ependymomas, and cavernous malformations (discussion of these entities is beyond the scope of this discussion). Intra- operative monitoring of spinal cord function is essential during these surgeries. Tools such as the laser or the ultrasonic aspirator (a device which precisely fragments tissue and suctions it up at the same time) as well as careful microsurgical techniques have been found to be extremely valuable during tumor resection by minimizing trauma to the adjacent spinal cord fibers. Treatment involves surgery via a cervical laminectomy to obtain a tissue diagnosis as well as to debulk the tumor as completely as possible. Diagnosis depends on enhanced MRI scan of the cervical spine findings must be differentiated from transverse myelitis and acute inflammatory plaques of multiple sclerosis. ![]() These include weakness, poorly localized pain, gait difficulty, and sensory loss that are not in the normal distribution of a nerve or nerve root, as well as bowel and bladder involvement. Tumors known as astrocytomas (also called gliomas) arise within the supporting cells of the spinal cord and cause signs and symptoms due to pressure on the adjacent nerve fibers. Most intramedullary tumors are benign only 2% are malignant. Intradural extramedullary tumors: 75% of primary spinal tumors those arising within the dural covering of the spinal cord but outside the cord tissue itself. Intramedullary tumors: 25% of primary spinal tumors those arising from the tissue of the spinal cord itself. Primary tumors of the cervical spine are divided into two main groups based on location of originĪnd their relationship to the dura (the membrane that surround the spinal cord and nerve roots):
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