Microsurgical Removal of Spinal Tumors

Tumors of the spinal cord are rare neoplasms which occur in a minority of the general population. The traditional classification of spinal neoplasms is based on the relationship of the lesion with the dura mater dividing them into extradural, intradural extramedullary (IDEM), or intramedullary (IM), and it is currently used in the general practice. All the possible differential diagnoses and the optimal surgical or nonsurgical treatment of these lesions are strictly dependent on their compartmental location. Neuroradiological imaging assists the neurosurgeon in establishing the exact location of the tumors through the spinal cord and in the decision-making of the optimal surgical approach even if the involvement of different compartments could not be established preoperatively in some cases. Intraoperative neurological monitoring tools are crucial in spine surgery in order to balance tumor removal with the preservation of neurological function. Encompassing a wide range of diseases, spine tumors require prompt multidisciplinary treatment strategies, being variously approached not only by surgical interventions but also by chemotherapy, radiotherapy either alone or in various combinations. In order to improve the functional and postoperative outcomes, emerging technologies started being incorporated routinely into spine surgery as complementary tools for better surgical results. Most importantly, the knowledge of specific anatomic features guides surgical strategies and individual approach top the lesions.