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Intramedullary Spinal Cord Tumors in the Elderly Patient
Max Ward1, Ethan D L Brown1, Apratim Maity1
1Northwell Health, Department of Neurosurgery, Manhasset, NY 11030, USA; Department of Neurosurgery, Donald and Barbara Zucker Hofstra School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA.
Neurosurgery Clinics of North America
|June 9, 2026
Summary
Managing spinal cord tumors in older adults focuses on frailty, not just age, for better outcomes. Surgery offers good results for well-chosen elderly patients, prioritizing quality of life.
Area of Science:
- Neurosurgery
- Geriatric Oncology
Background:
- Intramedullary spinal cord tumors (ISCTs) in patients over 65 present unique management challenges.
- Balancing oncological control and functional preservation is paramount in this demographic.
Purpose of the Study:
- To outline an individualized approach for managing ISCTs in elderly patients.
- To emphasize frailty assessment over chronological age for treatment decisions.
Main Methods:
- Review of current literature and clinical guidelines for ISCT management in older adults.
- Focus on individualized patient assessment, including frailty and neurological status.
- Surgical strategies: gross total resection for well-demarcated tumors and maximal safe debulking for infiltrative types.
Main Results:
- Well-selected elderly patients can achieve good surgical outcomes.
- Delayed diagnosis frequently results in advanced neurological deficits, impacting recovery.
- Adjuvant therapies have a controversial role, requiring careful consideration.
Conclusions:
- Frailty assessment is key for selecting elderly patients for ISCT surgery.
- Surgical goals should be tailored to tumor type (resection vs. debulking).
- Prioritizing patient quality of life is essential when considering all treatment options.
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