{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T02:53:45Z","timestamp":1776999225499,"version":"3.51.4"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The rate of dorsal column deficit after intramedullary spine tumor resection remains unknown. In a cohort of patients undergoing posterior intramedullary spinal tumor resection, the authors sought to 1) report the rate of dorsal column deficits, 2) report the rate of new motor deficits, and 3) determine risk factors and recovery characteristics for both deficits.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A single-institution, retrospective cohort study of patients undergoing posterior intramedullary spinal cord tumor resection was performed from 2010 to 2020. Primary and metastatic cord tumors were included; cauda equina tumors and patients not undergoing midline myelotomy were excluded. Exposure variables included posterior midline myelotomy, tumor location within the spinal cord, spinal segment, tumor size, presence of cord edema on preoperative imaging, and complete\/partial resection. The primary outcome was dorsal column deficit (new numbness\/tingling, diminished fine touch, vibration, or 2-point discrimination, or balance\/proprioceptive problems). Descriptive statistics were performed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of 34 patients undergoing intramedullary tumor resection, the mean \u00b1 SD age was 44.4 \u00b1 12.1 years and 55.9% were male. Histological analysis showed that 22 (64.7%) patients had ependymoma, 3 (8.8%) astrocytoma, 2 (5.9%) glioblastoma, 2 (5.9%) low-grade glioma, 2 (5.9%) lung adenocarcinoma, and 1 (2.9%) each of hemangioblastoma, lipoma, and necrosis possible neoplasm. Tumor locations were cervical in 17 (50.0%) patients, thoracic in 15 (44.1%), and thoracolumbar\/conus in 2 (5.9%). Complete resection was achieved in 19 (55.9%) patients. At presentation, 26 (76.5%) patients had dorsal column deficits and 17 (50%) had motor deficits. Deficits worsened in 17\/26 patients with preoperative motor deficits, remained the same in 9, and improved in 0. In 8 patients without preoperative dorsal column deficits, 7 had new dorsal column deficit and 1 had none. A postoperative dorsal column deficit was seen in 33\/34 (97%) patients. At the most recent follow-up, 6\/33 (18%) patients had improvement in dorsal column deficits and 27\/33 (82%) had stable deficits.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Postoperative dorsal column deficits occurred in 97% patients who underwent midline myelotomy for intramedullary tumor resection. Dorsal column deficits improved in 18% yet remained stable in the remaining 82%. Motor deficits improved in only 12% and remained stable\/worsened in 88%. These results highlight the high rate of dorsal column deficits in patients requiring midline myelotomy for resection of intramedullary tumors.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.3.spine241643","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T15:56:32Z","timestamp":1757951792000},"page":"257-264","source":"Crossref","is-referenced-by-count":1,"title":["Are dorsal column deficits inevitable in intramedullary spine tumor resection?"],"prefix":"10.3171","volume":"43","author":[{"given":"Iyan","family":"Younus","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander T.","family":"Lyons","sequence":"additional","affiliation":[{"name":"School of Medicine, Vanderbilt University, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Ye","sequence":"additional","affiliation":[{"name":"School of Medicine, Vanderbilt University, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsh","family":"Jain","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Chanbour","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambika E.","family":"Paulson","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Zakieh","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Orthopedic Surgery, Vanderbilt University Medical Center, Nashville; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Acta Neuropathol","first-page":"803","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis DN","year":"2016","unstructured":"Louis DN, Perry A, Reifenberger G, The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131(6):803\u2013820."},{"issue":"5","key":"b2","series-title":"Global Spine J","first-page":"425","article-title":"Intramedullary spinal cord tumors: part I\u2014epidemiology, pathophysiology, and diagnosis","volume":"5","author":"Samartzis D","year":"2015","unstructured":"Samartzis D, Gillis CC, Shih P, Intramedullary spinal cord tumors: part I\u2014epidemiology, pathophysiology, and diagnosis. Global Spine J. 2015;5(5):425\u2013435."},{"issue":"2","key":"b3","series-title":"Neurosurg Clin N Am","first-page":"237","article-title":"Surgical management of intramedullary spinal cord tumors","volume":"31","author":"Hussain I","year":"2020","unstructured":"Hussain I, Parker WE, Barzilai O, Surgical management of intramedullary spinal cord tumors. Neurosurg Clin N Am. 2020;31(2):237\u2013249."},{"issue":"1","key":"b4","series-title":"J Neurosurg Spine","first-page":"12","article-title":"Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results","volume":"19","author":"Klekamp J","year":"2013","unstructured":"Klekamp J. Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine. 2013;19(1):12\u201326."},{"key":"b5","first-page":"e34","article-title":"What factors predict the development of neurologic deficits following resection of intramedullary spinal cord tumors: a multi-center study","volume":"182","author":"Akinduro OO","year":"2024","unstructured":"Akinduro OO, Ghaith AK, Loizos M, What factors predict the development of neurologic deficits following resection of intramedullary spinal cord tumors: a multi-center study. World Neurosurg. 2024;182:e34\u2013e44."},{"issue":"4","key":"b6","series-title":"J Spinal Disord Tech","first-page":"205","article-title":"Dorsal column mapping for intramedullary spinal cord tumor resection decreases dorsal column dysfunction","volume":"25","author":"Mehta AI","year":"2012","unstructured":"Mehta AI, Mohrhaus CA, Husain AM, Dorsal column mapping for intramedullary spinal cord tumor resection decreases dorsal column dysfunction. J Spinal Disord Tech. 2012;25(4):205\u2013209."},{"issue":"6","key":"b7","series-title":"J Neurosurg Spine","first-page":"623","article-title":"Utility of neurophysiological monitoring using dorsal column mapping in intramedullary spinal cord surgery","volume":"12","author":"Yanni DS","year":"2010","unstructured":"Yanni DS, Ulkatan S, Deletis V, Utility of neurophysiological monitoring using dorsal column mapping in intramedullary spinal cord surgery. J Neurosurg Spine. 2010;12(6):623\u2013628."},{"issue":"6","key":"b8","series-title":"J Spinal Cord Med","first-page":"535","article-title":"International standards for neurological classification of spinal cord injury (revised 2011)","volume":"34","author":"Kirshblum SC","year":"2011","unstructured":"Kirshblum SC, Burns SP, Biering-Sorensen F, International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34(6):535\u2013546."},{"issue":"5","key":"b9","series-title":"Neurosurg Focus","first-page":"E22","article-title":"Refining the treatment of spinal cord lesions: experience from 500 cases","volume":"50","author":"Westphal M","year":"2021","unstructured":"Westphal M, Mende KC, Eicker SO. Refining the treatment of spinal cord lesions: experience from 500 cases. Neurosurg Focus. 2021;50(5):E22."},{"issue":"2","key":"b10","series-title":"J Neurosurg Spine","first-page":"252","article-title":"Perioperative outcomes and survival after surgery for intramedullary spinal cord tumors: a single-institution series of 302 patients","volume":"37","author":"Hersh AM","year":"2022","unstructured":"Hersh AM, Patel J, Pennington Z, Perioperative outcomes and survival after surgery for intramedullary spinal cord tumors: a single-institution series of 302 patients. J Neurosurg Spine. 2022;37(2):252\u2013262."},{"issue":"5","key":"b11","series-title":"Rev Neurol (Paris)","first-page":"508","article-title":"Management of intramedullary spinal cord tumors: a single-center experience of 247 patients","volume":"177","author":"Knafo S","year":"2021","unstructured":"Knafo S, Aghakhani N, David P, Management of intramedullary spinal cord tumors: a single-center experience of 247 patients. Rev Neurol (Paris). 2021;177(5):508\u2013514."},{"issue":"2","key":"b12","series-title":"Neurosurg Q","first-page":"113","article-title":"Complications after treatment of intramedullary spinal cord tumors","volume":"17","author":"Wong C","year":"2007","unstructured":"Wong C, Conway J, Zareck M, Jallo GI. Complications after treatment of intramedullary spinal cord tumors. Neurosurg Q. 2007;17(2):113\u2013119."},{"issue":"6","key":"b1","series-title":"Acta Neuropathol","first-page":"803","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis DN","year":"2016","unstructured":"Louis DN, Perry A, Reifenberger G, The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131(6):803\u2013820."},{"issue":"5","key":"b2","series-title":"Global Spine J","first-page":"425","article-title":"Intramedullary spinal cord tumors: part I\u2014epidemiology, pathophysiology, and diagnosis","volume":"5","author":"Samartzis D","year":"2015","unstructured":"Samartzis D, Gillis CC, Shih P, Intramedullary spinal cord tumors: part I\u2014epidemiology, pathophysiology, and diagnosis. Global Spine J. 2015;5(5):425\u2013435."},{"issue":"2","key":"b3","series-title":"Neurosurg Clin N Am","first-page":"237","article-title":"Surgical management of intramedullary spinal cord tumors","volume":"31","author":"Hussain I","year":"2020","unstructured":"Hussain I, Parker WE, Barzilai O, Surgical management of intramedullary spinal cord tumors. Neurosurg Clin N Am. 2020;31(2):237\u2013249."},{"issue":"1","key":"b4","series-title":"J Neurosurg Spine","first-page":"12","article-title":"Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results","volume":"19","author":"Klekamp J","year":"2013","unstructured":"Klekamp J. Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine. 2013;19(1):12\u201326."},{"key":"b5","first-page":"e34","article-title":"What factors predict the development of neurologic deficits following resection of intramedullary spinal cord tumors: a multi-center study","volume":"182","author":"Akinduro OO","year":"2024","unstructured":"Akinduro OO, Ghaith AK, Loizos M, What factors predict the development of neurologic deficits following resection of intramedullary spinal cord tumors: a multi-center study. World Neurosurg. 2024;182:e34\u2013e44."},{"issue":"4","key":"b6","series-title":"J Spinal Disord Tech","first-page":"205","article-title":"Dorsal column mapping for intramedullary spinal cord tumor resection decreases dorsal column dysfunction","volume":"25","author":"Mehta AI","year":"2012","unstructured":"Mehta AI, Mohrhaus CA, Husain AM, Dorsal column mapping for intramedullary spinal cord tumor resection decreases dorsal column dysfunction. J Spinal Disord Tech. 2012;25(4):205\u2013209."},{"issue":"6","key":"b7","series-title":"J Neurosurg Spine","first-page":"623","article-title":"Utility of neurophysiological monitoring using dorsal column mapping in intramedullary spinal cord surgery","volume":"12","author":"Yanni DS","year":"2010","unstructured":"Yanni DS, Ulkatan S, Deletis V, Utility of neurophysiological monitoring using dorsal column mapping in intramedullary spinal cord surgery. J Neurosurg Spine. 2010;12(6):623\u2013628."},{"issue":"6","key":"b8","series-title":"J Spinal Cord Med","first-page":"535","article-title":"International standards for neurological classification of spinal cord injury (revised 2011)","volume":"34","author":"Kirshblum SC","year":"2011","unstructured":"Kirshblum SC, Burns SP, Biering-Sorensen F, International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34(6):535\u2013546."},{"issue":"5","key":"b9","series-title":"Neurosurg Focus","first-page":"E22","article-title":"Refining the treatment of spinal cord lesions: experience from 500 cases","volume":"50","author":"Westphal M","year":"2021","unstructured":"Westphal M, Mende KC, Eicker SO. Refining the treatment of spinal cord lesions: experience from 500 cases. Neurosurg Focus. 2021;50(5):E22."},{"issue":"2","key":"b10","series-title":"J Neurosurg Spine","first-page":"252","article-title":"Perioperative outcomes and survival after surgery for intramedullary spinal cord tumors: a single-institution series of 302 patients","volume":"37","author":"Hersh AM","year":"2022","unstructured":"Hersh AM, Patel J, Pennington Z, Perioperative outcomes and survival after surgery for intramedullary spinal cord tumors: a single-institution series of 302 patients. J Neurosurg Spine. 2022;37(2):252\u2013262."},{"issue":"5","key":"b11","series-title":"Rev Neurol (Paris)","first-page":"508","article-title":"Management of intramedullary spinal cord tumors: a single-center experience of 247 patients","volume":"177","author":"Knafo S","year":"2021","unstructured":"Knafo S, Aghakhani N, David P, Management of intramedullary spinal cord tumors: a single-center experience of 247 patients. Rev Neurol (Paris). 2021;177(5):508\u2013514."},{"issue":"2","key":"b12","series-title":"Neurosurg Q","first-page":"113","article-title":"Complications after treatment of intramedullary spinal cord tumors","volume":"17","author":"Wong C","year":"2007","unstructured":"Wong C, Conway J, Zareck M, Jallo GI. Complications after treatment of intramedullary spinal cord tumors. Neurosurg Q. 2007;17(2):113\u2013119."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/43\/3\/article-p257.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/43\/3\/article-p257.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/43\/3\/article-p257.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:35Z","timestamp":1772804735000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/43\/3\/article-p257.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":24,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2025.3.spine241643","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9,1]]}}}