Spinal cord gliomas are the most common type of primary intramedullary malignant tumors, with a low incidence and a peak onset age of approximately 35 years. They are slightly more prevalent in males than females. Clinical manifestations vary depending on tumor characteristics and location, typically presenting with axial pain and displaying a tendency for unilateral, infiltrative growth. Prognosis is generally poor, and effective treatment options are limited aside from surgical resection. Common surgical approaches for intramedullary tumor removal include the posterior median sulcus approach, the dorsolateral sulcus approach, and surface entry techniques.
Preliminary clinical observations suggest that the dorsolateral sulcus approach may offer superior preservation of neurological function and quality of life. However, due to limited research evaluating the safety and efficacy of different surgical routes, the traditional posterior median sulcus approach remains widely used.
This single-center, registry-based cohort study aims to compare the outcomes of spinal cord glioma resection via the dorsolateral sulcus approach versus the posterior median sulcus approach. Patients with laterally located tumors undergoing surgical treatment, classified according to the 2021 WHO criteria, will be included. Neurological function scores and quality-of-life assessments will be used to evaluate prognosis and survival, in order to determine the optimal surgical approach for spinal cord glioma resection.
Eligibility
Sex
ALL
Min age
3 Years
Max age
75 Years
Healthy volunteers
No
Inclusion Criteria:
1. Age between 3 and 75 years
2. Undergoing surgical resection of spinal cord tumor
3. Histopathological diagnosis of spinal cord glioma based on routine pathological examination
4. Availability of complete clinical data and willingness to participate in follow-up
5. Informed consent obtained from the patient and/or legal guardians or immediate family members
Exclusion Criteria:
1. Age under 3 years or over 75 years
2. Receipt of radiotherapy, chemotherapy, or anti-tumor biological therapy within 1 month prior to enrollment
3. Receipt of immunotherapy within 3 months prior to enrollment
4. Participation in other clinical trials within 3 months prior to enrollment
5. History of severe allergic reactions or known allergy-prone constitution
6. Pregnant or breastfeeding women, or individuals of childbearing potential not using adequate contraception
7. Presence of other severe medical conditions or uncontrolled infections
8. History of drug abuse, substance misuse, chronic alcoholism, or HIV infection
9. Uncontrolled epileptic seizures or psychiatric disorders resulting in loss of self-control
Primary outcome measure(s)
Extent of resection — Preoperative MRI and MRI re-examinations conducted within 3 days after the surgery The extent of tumor resection was evaluated by comparing the preoperative and postoperative magnetic resonance images, and the criterion for judgment was that the tumor volume decreased by more than 50%.
Number of Participants with Preserved Dorsal Column Function (Assessed by clinical neurological examination and intraoperative electrophysiological monitoring ) — Preoperative, 1 month, 6 months Dorsal column function will be assessed through standardized clinical neurological examination, including evaluation of proprioception (joint position sense), vibration sense, and gait. Dysfunction is defined as the presence of generalized numbness or painful dysesthesias below the surgical level, accompanied by proprioceptive loss and/or gait disturbance. \* This definition is based on previously published clinical criteria for dorsal column dysfunction in patients with intramedullary spinal cord tumors, as described by Manzano et al.
Pain Level (VAS Score) — Preoperative, 1 month postoperative, 6 months postoperative, and 12 months postoperative Assessment of pain severity using the Visual Analog Scale (VAS), with scores ranging from 0 (no pain) to 100 (worst possible pain).
Neurological Functional Status (McCormick Grade) — Preoperative, 1 month postoperative, 3 months postoperative, 6 months postoperative, and 12 months postoperative Evaluation of neurological status using the McCormick Functional Grading Scale to compare surgical approaches. The scale ranges from Grade I (normal gait and function) to Grade IV (severe disability or paraplegia).
Trial sites (1)
Facility
City
Region
Status
Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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