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Brain Science Advances 2017, 3(1): 28-34 https://doi.org/10.18679/CN11-6030_R.2017.004
Original Article | Open Access | Issue | Published: 01 March 2017

Resection of intramedullary spinal cord tumor under awake anesthesia: A novel approach to minimize postoperative motor deficits

Show Author's Information Ahsan Ali Khan1,  Lukui Chen1( ),  Xiaoyuan Guo1,  Hong Wang1,  Guojian Wu1,  Jun Kong1,  Ning Yin2
Department of Neurosurgery, Zhongda Hospital, Southeast University, Nanjing 210009, China
Department of Anaesthesia, Zhongda Hospital, Southeast University, Nanjing 210009, China
Keywords:
spinal cord, tumor, intramedullary, awake, neurophysiological monitoring
Cite this article:
Khan AA, Chen L, Guo X, et al. Resection of intramedullary spinal cord tumor under awake anesthesia: A novel approach to minimize postoperative motor deficits. Brain Science Advances, 2017, 3(1): 28-34. https://doi.org/10.18679/CN11-6030_R.2017.004
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Abstract Full text About this article
Objective:

To observe advantages and disadvantages of the resection of intramedullary spinal cord tumor under awake anesthesia.

Methods:

Two patients with intramedullary spinal cord tumor underwent resection under awake anesthesia and followed up post-operatibely for any motor deficits.

Results:

Patients who underwent tumor resection under awake (AAA) anesthesia combined with intraoperative NPM had no motor deficits postoperatively. More accurate and nondelayed responses were observed in the awake cycle of anesthesia and helped guide surgery, thus avoiding injuries to the spinal cord.

Conclusion:

Intramedullary spinal cord tumors are not common, but only gross total resection (GTR) can provide complete remission of symptoms and progression-free survival. However, GTR sometimes results in motor function deficits postoperatively, particularly when the cervical cord is involved, and especially if surgery is done under general anesthesia with intraoperative neurophysiological monitoring (NPM) alone, because of delayed sensory evoked potential and motor evoked potential responses. We present two cases that underwent GTR of cervical intramedullary spinal cord tumors under an asleep-awake-asleep (AAA) cycle of anesthesia, combined with intraoperative NPM in which no post-operative motor deficits were observed on 6-months follow up.


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Abstract
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About this article

Resection of intramedullary spinal cord tumor under awake anesthesia: A novel approach to minimize postoperative motor deficits

Show Author's information Ahsan Ali Khan1, Lukui Chen1( ), Xiaoyuan Guo1, Hong Wang1, Guojian Wu1, Jun Kong1, Ning Yin2
Department of Neurosurgery, Zhongda Hospital, Southeast University, Nanjing 210009, China
Department of Anaesthesia, Zhongda Hospital, Southeast University, Nanjing 210009, China

Abstract

Objective:

To observe advantages and disadvantages of the resection of intramedullary spinal cord tumor under awake anesthesia.

Methods:

Two patients with intramedullary spinal cord tumor underwent resection under awake anesthesia and followed up post-operatibely for any motor deficits.

Results:

Patients who underwent tumor resection under awake (AAA) anesthesia combined with intraoperative NPM had no motor deficits postoperatively. More accurate and nondelayed responses were observed in the awake cycle of anesthesia and helped guide surgery, thus avoiding injuries to the spinal cord.

Conclusion:

Intramedullary spinal cord tumors are not common, but only gross total resection (GTR) can provide complete remission of symptoms and progression-free survival. However, GTR sometimes results in motor function deficits postoperatively, particularly when the cervical cord is involved, and especially if surgery is done under general anesthesia with intraoperative neurophysiological monitoring (NPM) alone, because of delayed sensory evoked potential and motor evoked potential responses. We present two cases that underwent GTR of cervical intramedullary spinal cord tumors under an asleep-awake-asleep (AAA) cycle of anesthesia, combined with intraoperative NPM in which no post-operative motor deficits were observed on 6-months follow up.

Keywords: spinal cord, tumor, intramedullary, awake, neurophysiological monitoring

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Publication history
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Publication history

Received: 22 December 2016
Revised: 16 January 2017
Accepted: 28 February 2017
Published: 01 March 2017
Issue date: March 2017

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© The authors 2017.

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This article is published with open access at www.TNCjournal.com

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