Spinal intramedullary CMs are clinically more aggressive than their intracranial counterparts.11) Due to space occupying growth, recurrent micro-bleeding or significant hemorrhage spinal CMs can lead to severe neurological deteriorations. The decision between conservative management and surgical treatment of intramedullary CMs is discussed controversially and the opinions diverge. The choice of microsurgical treatment of symptomatic intramedullary CMs is usually made on a case-by-case basis. The aim of this study was to present data of microsurgically treated patients with symptomatic intramedullary CMs in our department and to discuss about the optimal surgical timing according to clinical manifestations.
8 patients with spinal intramedullary CM were enrolled who treated with surgical resection in the department of neurosurgery at our single institute between March 2007 and March 2012. The medical records, radiographic images, intraoperative photographs, neurologic examinations, preoperative and postoperative clinical findings of all patients were reviewed retrospectively.
In Group I (early resection), the average McCormick classification at follow-up was 3.0 +-0.8, which was clinically improved compared with 3.25 +- 0.5 before surgery. However, this was not statistically significant (p > 0.05). In Group II (delayed resection), the average McCormick classification at follow-up was 1.5 +- 0.5, which was statistically improved compared with 2.5 +- 0.5 before surgery (p < 0.05).
We suggest that a full understanding of clinical manifestations, optimal surgical timing and complete resection of intramedullary CM can guide to make a favorable clinical outcome.