Surgical management of spinal intramedullary tumors

The surgical management of intramedullary spinal cord tumors (IMSCT) remains a major clinical challenge for neurosurgeons. IMSCTs arise from the spinal cord itself, leading to invasion and destruction of gray and white matter¹. They account for 2 – 4% of all primary central nervous system tumors (CNS tumors) and 20 – 30% of all spinal cord tumors². The most prevalent types of intramedullary spine cord tumors are gliomas such as astrocytomas and ependymomas, as well as hemangioblastomas¹.

The surgical resection of intramedullary tumors aims at maximizing the extent of tumor resection while minimizing damage to the spinal cord parenchyma to preserve neurological function. Therefore, surgeons are faced with the challenge of finding and inspecting the interface between tumor and spinal cord³. Gross total resection (GTR) of the tumor may become especially difficult in astrocytoma cases, where the infiltrative nature of the tumor leads to a poorly defined resection plane^1,3.

Maximizing extent of resection while preserving neurological function remains a major challenge in complex tumor cases, such as when resecting intramedullary spinal cord tumors. Visualization systems from ZEISS support neurosurgeons to gain greater certainty in their workflow by offering innovative visualization modalities for inspecting delicate anatomical structures. With the microscope integrated YELLOW 560 from ZEISS, fluorescence-stained structures are highlighted, while non-stained tissue is visualized in its natural-like color.⁴