Hiroto Kageyama, Kotaro Tatebayashi, Shinichi Yoshimura, Toshiki Endo, Kazutoshi Hida, Masaki Mizuno, for the Investigators of Intramedullary Spinal Cord Tumors in the Neurospinal Society of Japan
Neurospine 2023;20(2):678-691. Published online June 30, 2023
Objective Intramedullary spinal cord tumors (IMSCTs) are uncommon and difficult to treat. Studies examining the efficacy of rare IMSCT surgery in the elderly are limited. We conducted a subanalysis using multicenter retrospective-historical data provided by the Japan Neurospinal Society to compare surgical outcomes between older and younger adults with IMSCTs.
Methods We classified patients with IMSCTs into younger (aged 18–64 years) or older ( ≥ 65 years) groups. The primary outcomes of “improved” or “worsened” from the preoperative period to 6 months after surgery were evaluated using the modified McCormick scale (mMCs). A favorable outcome was defined as an mMCs grade of I/II at 6 months.
Results Among 841 patients registered, there were 658 younger (78.2%) and 183 older patients (21.8%) evaluated using mMCs at 6 months. Median preoperative mMCs grades were significantly worse in older patients than in younger patients. Neither the “improved” nor “worsened” rate differed significantly between the groups (28.1% vs. 25.1%; crude odds ratio [cOR], 0.86; 95% confidence interval [CI], 0.59–1.25; adjusted OR [aOR], 0.84; 95% CI, 0.55–1.28; 16.9% vs. 23.0%; cOR, 1.47; 95% CI, 0.98–2.20; aOR, 1.28; 95% CI, 0.83–1.97). Favorable outcomes were significantly less common among older adults in the univariate analysis but were not significant in the multivariate analysis (66.4% vs. 53.0%; cOR, 0.57; 95% CI, 0.41–0.80; aOR, 0.77; 95% CI, 0.50–1.19). In both younger and older patients, preoperative mMCs accurately predicted favorable outcomes.
Conclusion Age alone is not a sufficient reason to prohibit surgery for IMSCTs.
Citations
Citations to this article as recorded by
Clinical predictors of overall survival in pediatric patients with intramedullary spinal tumors: an analysis of the SEER database Arjit Singh, Saarang Patel, Jacob Gould, Noah Yaffe, Guan Li, Lou Blanpain, Julian Gendreau Child's Nervous System.2026;[Epub] CrossRef
Intramedullary Spinal Cord Tumors in the Elderly Patient Max Ward, Ethan D.L. Brown, Apratim Maity, Sheng-Fu Larry Lo, Daniel M. Sciubba Neurosurgery Clinics of North America.2026; 37(3): 363. CrossRef
Surgical outcomes of cervical spinal cord tumor in elderly patients assessed by the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire Shuhei Ito, Narihito Nagoshi, Toshiki Okubo, Masahiro Ozaki, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Morio Matsumoto, Masaya Nakamura, Kota Watanabe Spinal Cord.2025; 63(5): 239. CrossRef
Current Treatment Outcomes for Intramedullary Spinal Cord Tumors in Japan Toshiki Endo, Yoshiharu Takahashi, Taketo Nishizawa, Akira Ito, Tatsuya Sasaki Japanese Journal of Neurosurgery.2025; 34(6): 327. CrossRef
Prognostic Factors of Spinal Intramedullary Hemangioblastoma : Analysis of Surgical Outcomes and Tumor Characteristics Hyun-Jun Jang, Bong-Ju Moon, Kyung-Hyun Kim, Jeong-Yoon Park, Dong-Kyu Chin, Yong-Eun Cho, Keun-Su Kim Journal of Korean Neurosurgical Society.2024; 67(6): 637. CrossRef
The Inside Story of the Multi–center Studies in the Neurospinal Society of Japan Keisuke Takai Spinal Surgery.2024; 38(2): 105. CrossRef
An overview of intramedullary spinal cord metastases accompanied by a 2D intraoperative video Nehemiah Stewart, Brandon Lee, George Bourdages, Michael Galgano Surgical Neurology International.2024; 15: 461. CrossRef
Current Trends and Future Perspective of Intramedullary Spinal Cord Tumor Treatments Toshiki Endo, Yoshiharu Takahashi, Taketo Nishizawa, Tatsuya Sasaki Japanese Journal of Neurosurgery.2024; 33(6): 408. CrossRef
First
Prev
