Description of the Diversity in Surgical Indication and Surgical Strategies for Primary Spinal Cord Tumors: A Nationwide Survey by the Neurospinal Society of Japan

Yasukazu Hijikata, Shigeo Ueda, Takao Yasuhara, Daisuke Umebayashi, Toshiki Endo, Toshihiro Takami, Masaki Mizuno, Kazutoshi Hida, Minoru Hoshimaru

Research output: Contribution to journalArticlepeer-review

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 tu-mors; and ependymoma, hemangioblastoma, astrocytoma, and cavernoma as intramedul-lary 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 aca-demic societies.

Original languageEnglish
Pages (from-to)1122-1129
Number of pages8
JournalNeurospine
Volume19
Issue number4
DOIs
Publication statusPublished - Dec 2022

Keywords

  • General surgery
  • Registries
  • Spinal cord neoplasms
  • Surgical strategy
  • Surveys and ques-tionnaires

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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