Microsurgical removal of intramedullary spinal cord tumours: report of 22 cases.

The management of patients with intramedullary spinal cord tumours is controversial. The authors have treated these tumours in accordance with the principles of radical resection, using microsurgical techniques. There have been 22 cases of intramedullary spinal cord tumours (4 astrocytomas, 3 glioblastoma multiformes, 5 ependymomas, 7 haemangioblastomas, 1 dermoid, 1 lipoma and 1 schwannoma) thus treated at our department during the past 13 years. Sixteen were adults and six were children. The early and late results of their surgical treatment have been analyzed, with follow-up periods ranging from 10 months to 12 years. Of the 22 patients, total removal was performed in 16, subtotal removal in 5 and biopsy in 1. Guidetti's criteria were adopted in assessing the results of surgery. Long-term results were as follows: 8 very good, 5 good, 3 fair, 3 poor and 3 deceased. The 3 latter cases were glioblastoma multiformes. Gross total removal of intramedullary tumours is technically feasible and compatible with neurological recovery. Since the majority of intramedullary tumours are benign and their course may span not only years but decades, long-term follow-up is essential.