{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:36:11Z","timestamp":1780637771613,"version":"3.54.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"European Association of Neurosurgical Societies, Belgium","award":["EANS Research Grant 2020"],"award-info":[{"award-number":["EANS Research Grant 2020"]}]},{"DOI":"10.13039\/501100005296","name":"Universit\u00e4tsklinikum Regensburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005296","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Purpose<\/jats:title>\n                    <jats:p>Resection is the therapy of choice for cervicothoracic intramedullary spinal cord tumors (ctIMSCTs). While coarse neurological outcome has been multiply reported, more detailed data on longer-term outcome of quality-of-life (QoL) aspects as well as functional and neurological status\u00a0are still scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We prospectively assessed\u00a0all patients undergoing ctIMSCT surgery with IONM in our neurosurgical center between 2017 and 2023. Detailed neurological and functional status as well as McCormick Score, Barthel Index (BI) and physical &amp; mental QoL via Short-Form-36-Health-Survey Score (SF36-P\/MCS) were assessed pre- and immediately postoperatively and regularly during long-term follow-up (median: 25\u00a0months) and correlated with patients\u2019 and tumor characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      40 patients (m\/f: 26\/14) with a median age of 47\u00a0years were enrolled. In 78% and 22% of the patients tumors were located in the cervical and thoracic spine. Preoperatively, motor deficits were present in 40%, sensory disturbances in 78% and gait ataxia (proprioceptive deficits) in 38%; median McCormick Score was 1, mean SF36-PCS and SF36-MCS were 45.1 and 43.3, and median BI was 100 in the overall cohort. Gross-total resection rate was 88%. At last follow-up, 80% of the patients had a postoperative improved\/stable course in motor, 25% in sensory and 75% in gait function compared to the preoperative status. The overall cohort\u2019s median McCormick-Score was 1, while the mean SF36-PCS and SF36-MCS were 44.5 and 44.5 and the median BI was 100 (each with no significant differences compared to the preoperative status). Rates for individual improvement\/stability\/deterioration were 30%\/33%\/37% for physical QoL aspects and 33%\/35%\/32%\u00a0for mental QoL aspects. Presence of a permanent postoperatively new\/worsened sensory deficit (OR\u2009=\u20090.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and a preoperatively higher SF36-PCS (OR\u2009=\u20090.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) were significantly associated with a worse follow-up outcome regarding physical QoL perception.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Quality-of-life and motor\/gait function improves\/stabilizes in the majority of patients during follow-up after ctIMSCTs resection. Persistence of a postoperative deterioration in sensory function and a higher preoperative QoL\u00a0perception are factors associated with a worse physical QoL follow-up outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-026-06836-0","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T16:27:13Z","timestamp":1774456033000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Quality-of-life and detailed functional outcome after IONM-aided microsurgical resection of cervical and thoracic intramedullary spinal cord tumors in adults"],"prefix":"10.1007","volume":"168","author":[{"given":"Sebastian","family":"Siller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Duell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Reyhaniye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Kramer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick N.","family":"Harter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Ringel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zausinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg-Christian","family":"Tonn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Szelenyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"issue":"2","key":"6836_CR1","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.jocn.2012.01.056","volume":"20","author":"S Bansal","year":"2013","unstructured":"Bansal S, Ailawadhi P, Suri A, Kale SS, Sarat Chandra P, Singh M, Kumar R, Sharma BS, Mahapatra AK, Sharma MC, Sarkar C, Bithal P, Dash HH, Gaikwad S, Mishra NK (2013) Ten years\u2019 experience in the management of spinal intramedullary tumors in a single institution. J Clin Neurosci 20(2):292\u2013298","journal-title":"J Clin Neurosci"},{"key":"6836_CR2","doi-asserted-by":"crossref","unstructured":"Compston A (2010) Aids to the investigation of peripheral nerve injuries. Medical Research Council. Nerve Injuries Research Committee. His Majesty's Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O'Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. 8 64 and 94 Figures. Brain 133(10):2838\u20132844","DOI":"10.1093\/brain\/awq270"},{"issue":"2 Suppl","key":"6836_CR3","first-page":"183","volume":"93","author":"S Constantini","year":"2000","unstructured":"Constantini S, Miller DC, Allen JC, Rorke LB, Freed D, Epstein FJ (2000) Radical excision of intramedullary spinal cord tumors. Surgical morbidity and long-term follow-up evaluation in 164 children and young adults. J Neurosurg 93(2 Suppl):183\u2013193","journal-title":"J Neurosurg"},{"issue":"6","key":"6836_CR4","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1097\/00007632-199603150-00017","volume":"21","author":"LH Daltroy","year":"1996","unstructured":"Daltroy LH, Cats-Baril WL, Katz JN, Fossel AH, Liang MH (1996) The North American spine society lumbar spine outcome assessment instrument. Reliability and validity tests. Spine 21(6):741\u2013749","journal-title":"Spine"},{"issue":"4","key":"6836_CR5","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/s00701-009-0577-x","volume":"152","author":"CA Eroes","year":"2010","unstructured":"Eroes CA, Zausinger S, Kreth F-W, Goldbrunner R, Tonn J-C (2010) Intramedullary low grade astrocytoma and ependymoma. Surgical results and predicting factors for clinical outcome. Acta Neurochir (Wien) 152(4):611\u2013618","journal-title":"Acta Neurochir (Wien)"},{"issue":"5","key":"6836_CR6","doi-asserted-by":"publisher","first-page":"591","DOI":"10.3171\/2009.4.SPINE08159","volume":"11","author":"GL Garc\u00e9s-Ambrossi","year":"2009","unstructured":"Garc\u00e9s-Ambrossi GL, McGirt MJ, Mehta VA, Sciubba DM, Witham TF, Bydon A, Wolinksy J-P, Jallo GI, Gokaslan ZL (2009) Factors associated with progression-free survival and long-term neurological outcome after resection of intramedullary spinal cord tumors. Analysis of 101 consecutive cases. J Neurosurg Spine 11(5):591\u2013599","journal-title":"J Neurosurg Spine"},{"key":"6836_CR7","doi-asserted-by":"crossref","unstructured":"Karikari IO, Nimjee SM, Hodges TR, Cutrell E, Hughes BD, Powers CJ, Mehta AI, Hardin C, Bagley CA, Isaacs RE, Haglund MM, Friedman AH (2011) Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors. A single-center experience with 102 patients. Neurosurgery 68(1):188\u201397; discussion 197","DOI":"10.1227\/NEU.0b013e3181fe3794"},{"issue":"1","key":"6836_CR8","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3171\/2013.3.SPINE121063","volume":"19","author":"J Klekamp","year":"2013","unstructured":"Klekamp J (2013) Treatment of intramedullary tumors. Analysis of surgical morbidity and long-term results. J Neurosurg Spine 19(1):12\u201326","journal-title":"J Neurosurg Spine"},{"issue":"10","key":"6836_CR9","doi-asserted-by":"publisher","first-page":"663","DOI":"10.2176\/nmc.oa2012-0410","volume":"53","author":"D Li","year":"2013","unstructured":"Li D, Hao S-Y, Wu Z, Jia G-J, Zhang L-W, Zhang J-T (2013) Intramedullary medullocervical ependymoma\u2013surgical treatment, functional recovery, and long-term outcome. Neurol Med Chir (Tokyo) 53(10):663\u2013675","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"8","key":"6836_CR10","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","volume":"23","author":"DN Louis","year":"2021","unstructured":"Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, Hawkins C, Ng HK, Pfister SM, Reifenberger G, Soffietti R, von Deimling A, Ellison DW (2021) The 2021 WHO Classification of Tumors of the Central Nervous System. A summary Neuro Oncol 23(8):1231\u20131251","journal-title":"Summa Neuro Oncol"},{"key":"6836_CR11","first-page":"61","volume":"14","author":"FI Mahoney","year":"1965","unstructured":"Mahoney FI, Barthel DW (1965) Functional evaluation. The Barthel index. Md State Med J 14:61\u201365","journal-title":"Md State Med J"},{"issue":"4","key":"6836_CR12","doi-asserted-by":"publisher","first-page":"523","DOI":"10.3171\/jns.1990.72.4.0523","volume":"72","author":"PC McCormick","year":"1990","unstructured":"McCormick PC, Torres R, Post KD, Stein BM (1990) Intramedullary ependymoma of the spinal cord. J Neurosurg 72(4):523\u2013532","journal-title":"J Neurosurg"},{"key":"6836_CR13","doi-asserted-by":"publisher","first-page":"e614","DOI":"10.1016\/j.wneu.2020.01.126","volume":"136","author":"Y Nakanishi","year":"2020","unstructured":"Nakanishi Y, Naito K, Yamagata T, Takami T (2020) Health-related quality of life after microscopic total removal of spinal intramedullary ependymomas in a single-institute 3-year prospective study. World Neurosurg 136:e614\u2013e624","journal-title":"World Neurosurg"},{"issue":"1","key":"6836_CR14","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1001\/jama.1958.02990010025006","volume":"166","author":"GL Odom","year":"1958","unstructured":"Odom GL, Finney W, Woodhall B (1958) Cervical disk lesions. J Am Med Assoc 166(1):23\u201328","journal-title":"J Am Med Assoc"},{"issue":"2","key":"6836_CR15","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s10143-018-0957-x","volume":"42","author":"M Ottenhausen","year":"2019","unstructured":"Ottenhausen M, Ntoulias G, Bodhinayake I, Ruppert F-H, Schreiber S, F\u00f6rschler A, Boockvar JA, J\u00f6dicke A (2019) Intradural spinal tumors in adults-update on management and outcome. Neurosurg Rev 42(2):371\u2013388","journal-title":"Neurosurg Rev"},{"key":"6836_CR16","unstructured":"Raco A, Esposito V, Lenzi J, Piccirilli M, Delfini R, Cantore G (2005) Long-term follow-up of intramedullary spinal cord tumors. A series of 202 cases. Neurosurgery 56(5):972\u201381; discussion 972\u201381"},{"key":"6836_CR17","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/B978-0-12-819826-1.00019-3","volume":"186","author":"F Sala","year":"2022","unstructured":"Sala F, Skrap B, Kothbauer KF, Deletis V (2022) Intraoperative neurophysiology in intramedullary spinal cord tumor surgery. Handb Clin Neurol 186:229\u2013244","journal-title":"Handb Clin Neurol"},{"issue":"5","key":"6836_CR18","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1055\/s-0035-1549029","volume":"5","author":"D Samartzis","year":"2015","unstructured":"Samartzis D, Gillis CC, Shih P, O\u2019Toole JE, Fessler RG (2015) Intramedullary spinal cord tumors. Part I-epidemiology, pathophysiology, and diagnosis. Glob Spine J 5(5):425\u2013435","journal-title":"Glob Spine J"},{"issue":"2","key":"6836_CR19","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3171\/2013.11.PEDS13346","volume":"13","author":"C Schneider","year":"2014","unstructured":"Schneider C, Hidalgo ET, Schmitt-Mechelke T, Kothbauer KF (2014) Quality of life after surgical treatment of primary intramedullary spinal cord tumors in children. J Neurosurg Pediatr 13(2):170\u2013177","journal-title":"J Neurosurg Pediatr"},{"key":"6836_CR20","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59091611","author":"M Schwake","year":"2023","unstructured":"Schwake M, Ricchizzi S, Krahwinkel S, Maragno E, Schipmann S, Stummer W, Gallus M, Holling M (2023) Resection of intramedullary hemangioblastoma. Timing of surgery and its impact on neurological outcome and quality of life. Medicina (Kaunas). https:\/\/doi.org\/10.3390\/medicina59091611","journal-title":"Medicina (Kaunas)"},{"key":"6836_CR21","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.clinph.2024.10.007","volume":"168","author":"S Siller","year":"2024","unstructured":"Siller S, Duell S, Tonn J-C, Szelenyi A (2024) Multimodal intraoperative neurophysiological monitoring may better predict postoperative distal upper extremities\u2019 complex-functional outcome than spinal and muscular motor evoked potentials alone in high-cervical intramedullary spinal cord tumor surgery. Clin Neurophysiol 168:52\u201360","journal-title":"Clin Neurophysiol"},{"key":"6836_CR22","doi-asserted-by":"crossref","unstructured":"Tropeano MP, Rossini Z, Franzini A, Baram A, Creatura D, Raspagliesi L, Pessina F, Fornari M (2024) Predictive factors of long-term neurological outcome and progression-free survival in intramedullary spinal cord tumors. A 10-year single-center cohort study and review of the literature. World Neurosurg","DOI":"10.1016\/j.wneu.2024.04.024"},{"key":"6836_CR23","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1136223","volume":"14","author":"T Tufo","year":"2023","unstructured":"Tufo T, Grande E, Bevacqua G, Di Muccio I, Cioni B, Meglio M, Ciavarro M (2023) Long-term quality of life and functional outcomes in adults surgically treated for intramedullary spinal cord tumor. Front Psychol 14:1136223","journal-title":"Front Psychol"},{"issue":"11","key":"6836_CR24","doi-asserted-by":"publisher","first-page":"3493","DOI":"10.1007\/s00701-023-05554-1","volume":"165","author":"M Ueberschaer","year":"2023","unstructured":"Ueberschaer M, Breitkopf K, Siller S, Katzendobler S, Weller J, Greve T, Zausinger S, Tonn J-C, Szelenyi A (2023) Dorsal column mapping in resection of intramedullary spinal cord tumors. A prospective comparison of two methods and neurological follow-up. Acta Neurochir Wien 165(11):3493\u20133504","journal-title":"Acta Neurochir Wien"},{"key":"6836_CR25","unstructured":"Ware J, Kosinski M, Bjorner J, Turner-Bowker D, Gandek B, Maruish M (2007) Development. User\u2019s Manual for the SF-36v2\u00ae Health Survey. QualityMetric Incorporated, Lincoln (RI)"},{"issue":"6","key":"6836_CR26","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1227\/NEU.0000000000001147","volume":"78","author":"R Xiao","year":"2016","unstructured":"Xiao R, Miller JA, Abdullah KG, Lubelski D, Mroz TE, Benzel EC (2016) Quality of life outcomes following resection of adult intramedullary spinal cord tumors. Neurosurgery 78(6):821\u2013828","journal-title":"Neurosurgery"},{"issue":"24","key":"6836_CR27","doi-asserted-by":"publisher","first-page":"2705","DOI":"10.1097\/BRS.0b013e3181b43484","volume":"34","author":"S Yang","year":"2009","unstructured":"Yang S, Yang X, Hong G (2009) Surgical treatment of one hundred seventy-four intramedullary spinal cord tumors. Spine Phila Pa 1976 34(24):2705\u20132710","journal-title":"Spine Phila Pa 1976"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-026-06836-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-026-06836-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-026-06836-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:06:22Z","timestamp":1774515982000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-026-06836-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6836"],"URL":"https:\/\/doi.org\/10.1007\/s00701-026-06836-0","relation":{},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"assertion":[{"value":"13 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local Institutional Review Board of the Ludwig-Maximilians-University Munich and agrees with all standards regarding the use of informed consent according to the guidelines of the local Institutional Review Board of the Ludwig-Maximilians-University Munich (Project # 17\u2013145).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all participants prior to their inclusion in the study according to the guidelines of the local Institutional Review Board of the Ludwig-Maximilians-University Munich (Project # 19\u2013560).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate\/consent to publish"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"86"}}