Surgery of Spinal Cord Tumors Based on Anatomy

Book excerpt: This book describes and illustrates an approach to surgery for spinal cord tumors that is based on a refined concept of anatomic compartmentalization. The aim of this approach is to enable maximum preservation of spinal cord function through confinement of the surgical work to the involved compartment or compartments. Importantly, this involvement differs according to tumor type, and the classification favored by the author takes this fully into account. After introductory chapters on epidemiology and pathology, the anatomy of the spinal cord relevant to surgery for spinal cord tumors is discussed in detail and the proposed classification is clearly explained. The surgical approach to each of the identified anatomic compartments is then described, with attention to the roles of intraoperative mapping techniques, diffusion tensor imaging, and electrophysiologic studies in ensuring that spinal cord functions are spared. Examples of the author’s experience when applying the proposed approach are presented. The book is meant for neurosurgeons at all levels of experience.