Holocord astrocytoma: a two-staged operative approach.

Biopsy or subtotal resection followed by radiation for intramedullary astrocytomas of the spinal cord offer palliation but not cure. A treatment modality using an ultrasonic suction device has revolutionized the treatment of these tumors and has been extended to include the treatment of intramedullary tumors involving the entire length of the spinal cord (holocord tumors) with evident success. An alternative to this technique, a two-staged microsurgical approach, allows complete excision of the tumor and thus offers a chance for cure. Two patients have been treated in this manner, and more than 3 years after the operations, both patients were still improving neurologically without any evidence of tumor recurrence.