Comparative clinical study on seldom segment with multiple segment intramedullary primary spinal cord tumors

Area of Science:

• Neurosurgery
• Spinal Cord Oncology
• Neurology

Background:

• Intramedullary primary spinal cord tumors can span multiple vertebral segments.
• Limited research exists on the impact of tumor segment length on neurological function and prognosis.

Purpose of the Study:

• To prospectively analyze and compare neurological function and prognosis in patients with seldom versus multiple segment intramedullary spinal cord tumors.

Main Methods:

• A prospective cohort study included 135 patients undergoing microsurgery for intramedullary spinal cord tumors.
• Tumors were classified as seldom (1-2 vertebral levels) or multiple (≥3 vertebral levels).
• Neurological function was assessed using the improved Japanese Orthopaedic Association (IJOA) scoring system pre- and post-operatively.

Main Results:

• Multiple segment tumors were associated with a higher incidence of limb weakness (75% vs 58%) and worse preoperative/early postoperative IJOA scores (P=0.02, P=0.004).
• No significant difference in urine/stool dysfunction was observed between groups (P=0.18).
• Long-term neurological function showed no significant difference (P=0.12), with notable improvement after physical therapy in the multiple segment group.

Conclusions:

• Seldom segment intramedullary tumors are associated with superior perioperative neurological function, particularly limb strength.
• Physical therapy is crucial for improving long-term neurological outcomes in patients with multiple segment tumors.