{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:59:34Z","timestamp":1790917174003,"version":"4.1.0"},"reference-count":102,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>Intramedullary spinal cord metastases (ISCM) represent a small proportion of intramedullary tumors. However, with the lifespans of patients with malignant tumors increasing, incidents of ISCM are on the rise. Due to threateningly severe disabilities in patients, accompanied by limited life expectancy, every attempt should be made to treat these tumors the same way as metastases elsewhere in the CNS, with the goal of complete removal of the ISCM and preservation of neurological functions. The object of this study is to retrospectively analyze the experiences of 22 patients who were surgically treated for ISCM over a 22-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Hospital charts of 22 patients, who were surgically treated for ISCM between 1992 and 2014, were reviewed retrospectively. Demographic data, histopathological diagnoses of primary cancer, chronological sequence of the disease, and neurological status using the simplified McCormick functional classification were collected and reanalyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The most frequent histology was metastasis of lung cancer, followed by brain and breast cancers. The time span from primary cancer diagnosis to the development of symptomatic spinal metastases ranged from 0 to 285 months, with a mean interval of 38 months. The leading presenting sign was dysesthesia (77% of the population), followed by paresis (68%). Only 5 patients (23%) showed urinary retention. Initial performance status represented by the McCormick Scale was on average 2.47. Total or near-total removal was achieved in 87% of cases. Compared with the clinical status 1\u22122 days after surgery, there was an improvement in the McCormick Scale grade at the last follow-up from 2.47 to 2.12 (p = 0.009). Likewise, an improvement was detected when comparing the preoperative status with the last follow-up (from 2.45 to 2.12; p = 0.029). The mean survival time after surgery was 11.6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These results suggest that surgery for intramedullary metastases\u2014with all of the challenges of a rare and potentially risky procedure\u2014can be beneficial to patients with advanced stages of cancer. Surgery can be performed with minimal new morbidity and results in maintaining neurological performance status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.5.focus15149","type":"journal-article","created":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T03:39:09Z","timestamp":1438400349000},"page":"E15","source":"Crossref","is-referenced-by-count":85,"title":["Intramedullary spinal cord metastases: an increasingly common diagnosis"],"prefix":"10.3171","volume":"39","author":[{"given":"Sebastian","family":"Payer","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Medical Center, Hamburg-Eppendorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus Christian","family":"Mende","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center, Hamburg-Eppendorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Med","family":"Pract","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center, Hamburg-Eppendorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Westphal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center, Hamburg-Eppendorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven O.","family":"Eicker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center, Hamburg-Eppendorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15149","series-title":"J Clin Neurosci","first-page":"1405","article-title":"Intramedullary spinal cord metastasis and multiple brain metastases from urothelial 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renal cell carcinoma: case report","volume":"31","author":"Donovan","year":"2006"},{"key":"b10-focus15149","series-title":"Eur Spine J","first-page":"1394","article-title":"The impact of fluorescence guidance on spinal intradural tumour surgery","volume":"22","author":"Eicker","year":"2013"},{"issue":"1","key":"b11-focus15149","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Clinical value of 2-deoxy-[18F]fluoro-D-glu-cose positron emission tomography in patients with cervical spondylotic myelopathy","volume":"35","author":"Eicker","year":"2013"},{"key":"b12-focus15149","series-title":"J Neurosurg","first-page":"729","article-title":"Intraoperative ultraso-nography: an important surgical adjunct for intramedullary tumors","volume":"74","author":"Epstein","year":"1991"},{"key":"b13-focus15149","series-title":"Ann Oncol","first-page":"1173","article-title":"Intramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: a series of six 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metastasis","volume":"52","author":"Hashii","year":"2011"},{"key":"b18-focus15149","series-title":"Int J Radiat Oncol Biol Phys","first-page":"349","article-title":"Spinal cord metastasis in small cell carcinoma of the lung","volume":"10","author":"Holoye","year":"1984"},{"key":"b19-focus15149","series-title":"Childs Nerv Syst","first-page":"113","article-title":"Spinal intramedullary metastasis of medulloblastoma at initial diagnosis","volume":"23","author":"Inoue","year":"2007"},{"key":"b20-focus15149","series-title":"Clin Neuropathol","first-page":"334","article-title":"Intramedullary spinal cord metastases of malignant melanoma: an autopsy case report and review of the literature","volume":"29","author":"Ishii","year":"2010"},{"key":"b21-focus15149","series-title":"Spinal Cord","first-page":"485","article-title":"Intramedullary spinal cord metastasis of ovarian tumor","volume":"42","author":"Isoya","year":"2004"},{"key":"b22-focus15149","series-title":"Acta Neurochir 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Problems and new concepts in the surgery of cerebral metastases","volume":"7","author":"Kamp","year":"2013"},{"key":"b25-focus15149","series-title":"Pediatr Neurosurg","first-page":"247","article-title":"Intraoperative spinal cord monitoring for intramedullary surgery: an essential adjunct","volume":"26","author":"Kothbauer","year":"1997"},{"key":"b26-focus15149","series-title":"J Neurooncol","first-page":"85","article-title":"Intramedullary spinal cord metastases: a single-institution experience","volume":"84","author":"Lee","year":"2007"},{"key":"b27-focus15149","series-title":"Br J Neurosurg","first-page":"278","article-title":"Intramedullary metastasis in a case of vermian medulloblastoma","volume":"26","author":"Madhugiri","year":"2012"},{"key":"b28-focus15149","series-title":"J Med Case Reports","first-page":"311","article-title":"Upper cervical intramedullary spinal metastasis of ovarian carcinoma: a case report and review of the 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Chir (Tokyo)","first-page":"546","article-title":"Long-term survival after surgical resection of primary spinal malignant melanoma","volume":"49","author":"Nishihara","year":"2009"},{"key":"b34-focus15149","series-title":"Cancer","first-page":"2583","article-title":"Intradural parenchymal involvement in the spinal subarachnoid space associated with primary lung cancer","volume":"72","author":"Okamoto","year":"1993"},{"key":"b35-focus15149","series-title":"J Korean Med Sci","first-page":"1253","article-title":"Intramedullary spinal cord metastasis in renal cell carcinoma: a case report of the surgical experience","volume":"28","author":"Park","year":"2013"},{"key":"b36-focus15149","series-title":"Clin Nucl Med","first-page":"837","article-title":"Intramedullary spinal cord metastasis from renal cell carcinoma: detection by positron emission tomography","volume":"26","author":"Poggi","year":"2001"},{"key":"b37-focus15149","series-title":"Lung 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of 423 cases","volume":"96","author":"Wiedemayer","year":"2002"},{"key":"b51-focus15149","series-title":"World Neurosurg","first-page":"370","article-title":"Survival and functional outcome after surgical resection of intramedullary spinal cord metastases","volume":"77","author":"Wilson","year":"2012"},{"key":"b1-focus15149","series-title":"J Clin Neurosci","first-page":"1405","article-title":"Intramedullary spinal cord metastasis and multiple brain metastases from urothelial carcinoma","volume":"18","author":"Abdulazim","year":"2011"},{"key":"b2-focus15149","series-title":"Br J Neurosurg","first-page":"474","article-title":"Intramedullary spinal cord metastases from a hypernephroma 11 years following the diagnosis and treatment of the primary lesion","volume":"14","author":"Ateaque","year":"2000"},{"key":"b3-focus15149","series-title":"Neurosurg Clin N Am","first-page":"45","article-title":"Intramedullary spinal cord metastasis: clinical management and surgical considerations","volume":"17","author":"Chi","year":"2006"},{"key":"b4-focus15149","series-title":"Clin Transl Oncol","first-page":"172","article-title":"Clinical outcome in patients with intramedullary spinal cord metastases from lung cancer","volume":"9","author":"Conill","year":"2007"},{"key":"b5-focus15149","series-title":"Surg Neurol","first-page":"329","article-title":"Intramedullary spinal cord metastasis: report of three cases and review of the literature","volume":"46","author":"Connolly","year":"1996"},{"issue":"2 Suppl","key":"b6-focus15149","series-title":"J Neurosurg","first-page":"183","article-title":"Radical excision of intramedullary spinal cord tumors: surgical morbidity and long-term follow-up evaluation in 164 children and young adults","volume":"93","author":"Constantini","year":"2000"},{"key":"b7-focus15149","series-title":"Neurosurgery","first-page":"E611","article-title":"Intramedullary spinal cord metastasis from bladder carcinoma: case report","volume":"63","author":"Crowley","year":"2008"},{"key":"b8-focus15149","series-title":"Clin Neurol Neurosurg","first-page":"10","article-title":"Retrospective study of 19 patients with intramedullary spinal cord metastasis","volume":"111","author":"Dam-Hieu","year":"2009"},{"key":"b9-focus15149","series-title":"Spine (Phila Pa 1976)","first-page":"E460","article-title":"Solitary intramedullary spinal cord tumor presenting as the initial manifestation of metastatic renal cell carcinoma: case report","volume":"31","author":"Donovan","year":"2006"},{"key":"b10-focus15149","series-title":"Eur Spine J","first-page":"1394","article-title":"The impact of fluorescence guidance on spinal intradural tumour surgery","volume":"22","author":"Eicker","year":"2013"},{"issue":"1","key":"b11-focus15149","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Clinical value of 2-deoxy-[18F]fluoro-D-glu-cose positron emission tomography in patients with cervical spondylotic myelopathy","volume":"35","author":"Eicker","year":"2013"},{"key":"b12-focus15149","series-title":"J Neurosurg","first-page":"729","article-title":"Intraoperative ultraso-nography: an important surgical adjunct for intramedullary tumors","volume":"74","author":"Epstein","year":"1991"},{"key":"b13-focus15149","series-title":"Ann Oncol","first-page":"1173","article-title":"Intramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: a series of six cases","volume":"12","author":"Fakih","year":"2001"},{"key":"b14-focus15149","series-title":"Turk Neurosurg","first-page":"294","article-title":"Intramedullary spinal cord metastasis of renal cell carcinoma 6 years following the nephrectomy","volume":"24","author":"Gao","year":"2014"},{"key":"b15-focus15149","series-title":"J Neurooncol","first-page":"163","article-title":"Surgical treatment of intramedullary spinal cord metastases of systemic cancer: functional outcome and 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Neuropathol","first-page":"334","article-title":"Intramedullary spinal cord metastases of malignant melanoma: an autopsy case report and review of the literature","volume":"29","author":"Ishii","year":"2010"},{"key":"b21-focus15149","series-title":"Spinal Cord","first-page":"485","article-title":"Intramedullary spinal cord metastasis of ovarian tumor","volume":"42","author":"Isoya","year":"2004"},{"key":"b22-focus15149","series-title":"Acta Neurochir (Wien)","first-page":"1347","article-title":"Intramedullary spinal cord metastases: diagnosis and treatment - an illustrated review","volume":"146","author":"Kalayci","year":"2004"},{"key":"b23-focus15149","series-title":"Int J Surg Oncol","first-page":"989506","article-title":"Current insights into surgery for intramedullary spinal cord metastases: a literature review","volume":"2011","author":"Kalita","year":"2011"},{"key":"b24-focus15149","series-title":"Ecancermedicalscience","first-page":"306","article-title":"The tumour is not enough or is it? 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