Updates on Management of Intramedullary Spinal Tumors

The management of intramedullary spinal cord tumors remains one of the most challenging clinical problems that one encounters as a spine surgeon. Here, as part of our NASS Spinal Oncology Podcast Series, Dr. Sheng-fu Larry Lo interviews Dr. Paul McCormick and Dr. George Jallo about updates and new research on the perioperative management of these lesions, including imaging features predicting resectability, tractography, intra-operative adjuncts to guide resection, extent of resection and outcomes, and the molecular landscape of these tumors.

Moderator: Hesham Soliman, MD, MSc
Medical College of Wisconsin, Milwaukee, WI

Chair: Sheng-fu (Larry) Lo, MHS
Northwell Neurosurgery, Great Neck, NY

George I. Jallo, MD
Johns Hopkins Hospital, Baltimore, MD

Paul McCormick, MD, MPH
New York-Presbyterian Hospital-Columbia, New York, NY

References:

Seaman SC, Bathla G, Park BJ, Woodroffe RW, Smith M, Menezes AH, Noeller J, Yamaguchi S, Hitchon PW. MRI characteristics and resectability in spinal cord glioma. Clin Neurol Neurosurg. 2021 Jan;200:106321.

Egger K, Hohenhaus M, Van Velthoven V, Heil S, Urbach H. Spinal diffusion tensor tractography for differentiation of intramedullary tumor-suspected lesions. Eur J Radiol. 2016 Dec;85(12):2275-2280.

Mensah-Brown KG, Germi JW, Quattrone F, Maloney-Wilensky E, Lee JYK, Chen HI, Schuster JM. Use of Second Window ICG in spinal cord biopsy of a mildly contrast-enhancing lesion: Technical note and review of the literature. Neurochirurgie. 2021 Jun 5:S0028-3770(21)00161-2.

Vetrano IG, Gennari AG, Erbetta A, Acerbi F, Nazzi V, DiMeco F, Prada F. Contrast-Enhanced Ultrasound Assisted Surgery of Intramedullary Spinal Cord Tumors: Analysis of Technical Benefits and Intra-operative Microbubble Distribution Characteristics. Ultrasound Med Biol. 2021 Mar;47(3):398-407.

Forbes JA, Teschan N, Jones SH, Parry P, Simonet L, Swamy NK. Cervical corpectomy for resection of ventral intramedullary capillary hemangioma with circumferential involvement of the anterior spinal artery: case report. J Neurosurg Spine. 2018 Aug;29(2):144-149.

McCormick KL, Alexiades N, McCormick PC. Microsurgical Resection of an Intramedullary Spinal Cord Hemangioblastoma Through an Anterior Cervical Approach: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown). 2021 Jan 13;20(2):E133.

Ushirozako H, Yoshida G, Imagama S, Kobayashi K, Ando K, Ando M, Kawabata S, Yamada K, Kanchiku T, Fujiwara Y, Taniguchi S, Iwasaki H, Shigematsu H, Tadokoro N, Takahashi M, Wada K, Yamamoto N, Funaba M, Yasuda A, Hashimoto J, Morito S, Takatani T, Tani T, Matsuyama Y. Efficacy of Transcranial Motor Evoked Potential Monitoring During Intra- and Extramedullary Spinal Cord Tumor Surgery: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research. Global Spine J. 2021 May 20:21925682211011443.

Wang YZ, Zhang YW, Liu WH, Chai RC, Cao R, Wang B, An SY, Jiang WJ, Xu YL, Yang J, Jia WQ. Spinal Cord Diffuse Midline Gliomas With H3 K27m-Mutant: Clinicopathological Features and Prognosis. Neurosurgery. 2021 May 20:nyab174.

Disclosures:

Jallo, George I.: Consulting: Johnson&Johnson (Financial, Honorarium for consulting on shunt design $1000/yr); Grants: Medtronic (C, Pediatric Fellowship support. THis is for the support of a pediatric neurosurgery fellow); Fellowship Support: Codman (C, This is support for the pediatric fellow, Paid directly to institution/employer).

Lo, Sheng-fu Larry: Nothing to Disclose

McCormick, Paul C.: Nothing to Disclose

Soliman, Hesham : Nothing to Disclose