Neurospine.
2022 Dec;19(4):1122-1129. 10.14245/ns.2244686.343.
Description of the Diversity in Surgical Indication and Surgical Strategies for Primary Spinal Cord Tumors: A Nationwide Survey by the Neurospinal Society of Japan
- Affiliations
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- 1Spine and Low Back Pain Center, Kitasuma Hospital, Kobe, Japan
- 2Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- 3Shin-Aikai Spine Center, Katano Hospital, Katano, Japan
- 4Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- 5Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
- 6Department of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- 7Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
- 8Department of Minimum-Invasive Neurospinal Surgery, Mie University Graduate School of Medicine, Tsu, Japan
- 9Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
- KMID: 2537377
- DOI: http://doi.org/10.14245/ns.2244686.343
Abstract
Objective
To assess the current management of primary spinal cord tumors (PSCTs) and determine whether and to what extent there are differences in surgical strategies for PSCTs.
Methods
The Neurospinal Society of Japan conducted a survey between April 1 and 30, 2021. Certified spine surgeons were requested for information on the frequency of surgeries in 2020 and the surgical strategies adopted for each PSCTs. The following tumor histologies were focused: schwannoma, meningioma, and cauda equina tumor as extramedullary tumors; and ependymoma, hemangioblastoma, astrocytoma, and cavernoma as intramedullary tumors. The participants were divided according to their response as follows: experts, who had experienced ≥ 100 surgeries for PSCTs, and nonexperts.
Results
Among 308 participants (63%), 35 (11%) were experts. The total number of PSCTs in 2020 was 802 of which 564 tumors were extramedullary and 223 were intramedullary. Schwannoma accounted for 53% of the extramedullary tumors, and ependymoma accounted for 39% of the intramedullary tumors. Surgical strategies significantly differed among both the experts and nonexperts groups. Some discrepancies in the adopted surgical strategies were observed between groups. Some of the nonexperts, and none of the experts, ruled out surgery for schwannomas (Eden type 4), astrocytomas, or cavernomas. Five nonexperts (2.2%), and none of the experts, resected the entire dura for meningiomas.
Conclusion
A nationwide survey revealed that a sufficient consensus did not exist regarding surgical strategies for PSCTs. A disease-specific registry for PSCTs is necessary in academic societies.
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