Tumors of the Spinal Canal: Surgical Approaches and Future Therapies

 

A state-of-the-art resource on current and future advances in the treatment of intradural spinal tumors 

Tumors of the spinal canal provide unique challenges in terms of surgical approaches and oncological treatment. Management requires in-depth knowledge of the intricate anatomical relationships between the tumors and normal spinal pathways, restricted corridors of entry, and limitations of drug penetration. Over the past few decades, significant strides have been made in the treatment of these tumors. Development of minimally invasive techniques and greater understanding of these pathologies has resulted in improved safety, precision, and outcomes. Tumors of the Spinal Canal: Surgical Approaches and Future Therapies by Ankit I. Mehta and esteemed contributors is the most comprehensive textbook written to date on this topic. 

The book starts with two opening chapters covering an overview and anatomy, followed by three sections and 11 chapters on intramedullary spinal tumors, intradural extramedullary tumors, and peripheral nerve tumors. The comprehensive review encompasses anatomy, pathophysiology, therapeutic and surgical advances, diverse surgical techniques, and future directions. Throughout the text, readers are provided with the necessary tools to master management of these clinically difficult tumors, from both a medical and surgical standpoint.

Key Highlights

Treatment algorithms, clinical study summaries, and differential diagnoses presented in reader-friendly tables enhance acquisition and retention of knowledge

Comprehensive analyses and pearls from masters provide insights on how to manage complications and improve patient outcomes

Discussion of current research innovations, clinical trials, and future directions that have the potential to change the treatment paradigm

Neurosurgical residents, spine fellows, and complex spine surgeons will benefit from reading this resource cover-to-cover, while the intradural spinal tumor treatment paradigms provide an invaluable clinical tool for neuro-oncologists and oncologists.

This book includes complimentary access to a digital copy on https://medone.thieme.com.

 

 

Table of Contents:

Preface

Contributors

1 Overview of Spinal Canal Tumors

1.1 Introduction

1.2 Differentiating Tumor Pathology and Neurological Mimickers

1.3 Research Areas and Future Therapies

1.4 Conclusion

2 Anatomy of the Spinal Cord and Nerve Roots

2.1 Introduction

2.2 Anatomy of the Vertebral Column and Vertebrae

2.2.1 The Vertebrae: General Features

2.2.2 The Vertebral Canal

2.2.3 The Intervertebral Foramina

2.3 Development of the Spinal Cord

2.3.1 Early Development

2.3.2 Neurodifferentiation in the Spinal Cord

2.3.3 Development of the Spinal Cord White Matter

2.3.4 Development of the Meninges

2.3.5 Length of the Spinal Cord in Relation to the Vertebral Column

2.4 General Anatomy of the Spinal Cord

2.4.1 The Anterior Median Fissure and Posterior Median Sulcus

2.4.2 Regions of the Spinal Cord

2.5 Internal Anatomy of the Spinal Cord

2.5.1 The Spinal Gray Matter

2.5.2 Neuronal Cell Groups: Rexed's Laminae

2.5.3 The Dorsal Horn

2.5.4 The Lateral and Ventral Horns

2.5.5 The Spinal White Matter

2.5.6 The Ascending White Matter Tracts

2.5.7 The Descending White Matter Tracts

2.5.8 The Propriospinal White Matter Pathways

2.5.9 The Track of Lissauer

2.6 The Meninges

2.6.1 The Dura Mater

2.6.2 The Epidural Space

2.6.3 The Subdural Space

2.6.4 The Arachnoid Mater

2.6.5 Cerebrospinal Fluid

2.6.6 The Pia Mater

2.6.7 The Intermediate Layer

2.7 The Vasculature of the Spinal Cord

2.7.1 The Longitudinal Arteries

2.7.2 The Segmental Spinal Arteries

2.7.3 The Segmental Radiculomedullary Feeder Arteries

2.7.4 The Intramedullary and Small Radial Arteries

2.7.5 Proper Oxygenation and Watershed Areas of the Spinal Cord

2.7.6 Venous Drainage of the Spinal Cord

2.7.7 The Anterior and Posterior Radiculomedullary Veins

2.8 Anatomy of the Spinal Nerves

2.8.1 Basic Anatomy of the Spinal Nerves

2.8.2 The Spinal Roots

2.8.3 The Spinal Ganglia

2.8.4 The Spinal Nerves Proper

2.8.5 Meningeal Nerves

2.9 Conclusion

References

Section I: Intramedullary Spinal Tumors

3 Intramedullary Spinal Tumors: Histopathology and Radiology

3.1 Introduction

3.2 Amputation Neuroma

3.2.1 Histopathology

3.2.2 Imaging Characteristic

3.3 Ependymoma

3.3.1 Histopathology

3.3.2 Imaging Characteristic

3.4 CNS Lymphoma

3.4.1 Histopathology

3.4.2 Imaging Characteristic

3.5 Ganglioglioma

3.5.1 Histopathology

3.5.2 Imaging Characteristic

3.6 Hemangioblastoma

3.6.1 Histopathology

3.6.2 Imaging Characteristic

3.7 Myxopapillary Ependymoma

3.7.1 Histopathology

3.7.2 Imaging Characteristic

3.8 Germ Cell Tumors

3.8.1 Histopathology

3.8.2 Imaging Characteristic

3.9 Astrocytoma

3.9.1 Histopathology

3.9.2 Imaging Characteristic

3.10 Melanoma.

3.10.1 Histopathology

3.10.2 Imaging Characteristic

3.11 Conclusion

References

4 Treatment of Intramedullary Spinal Cord Tumors

4.1 Introduction

4.2 Anatomy

4.3 Pathology

4.3.1 Epidemiology

4.3.2 Histology/Genetics

4.3.3 Radiology

4.4 Clinical Presentation

4.5 Treatment

4.5.1 Surgical Intervention Nuances

4.6 Surgical Outcome

4.7 Adjuvant Therapy

4.8 Conclusion

References

5 Electrophysiological Testing for Intramedullary Spinal Tumor Surgery

5.1 IONM Types

5.1.1 Somatosensory Evoked Potentials (SSEPs)

5.1.2 Motor Evoked Potentials (MEPs)

5.1.3 Myogenic Tc-MEPs (mTc-MEPs)

5.1.4 D-wave

5.1.5 Dorsal Column Mapping (DCM)

5.1.6 Hoffmann's Reflex

5.1.7 Electromyography (EMG)

5.2 Case Illustration

5.2.1 Surgical Procedure and IONM

5.3 Discussion

5.4 Conclusion

References

6 Intramedullary Spinal Cord Tumors: Current Research and Potential Therapeutics

6.1 Epidemiology of Intramedullary Spinal Cord Tumors

6.2 Diagnosis of Intramedullary Spinal Cord Tumors

6.3 Current Research and Potential Surgical Therapies for Intramedullary Spinal Cord Tumors

6.3.1 Introduction

6.3.2 Therapeutic Advances

6.4 Current Research and Potential Systemic and 55 Nonsurgical Therapies for Intramedullary Spinal Cord Tumors

6.4.1 Introduction

6.4.2 Therapeutic Advances

6.5 Conclusion

References

Section II: Intradural Extramedullary Tumors

7 Intradural Extramedullary Spinal Tumors: Histopathology and Radiology

7.1 Nerve Sheath Tumors

7.1.1 Nerve Sheath Tumor Radiology

7.1.2 Nerve Sheath Tumor Histology

7.2 Meningiomas

7.2.1 Meningioma Radiology

7.2.2 Meningioma Histology

7.3 Paragangliomas

7.3.1 Paraganglioma Radiology

7.3.2 Paraganglioma Histology

7.4 Myxopapillary Ependymomas

7.4.1 Myxopapillary Ependymoma Radiology

7.4.2 Myxopapillary Ependymoma Histology

7.5 Leptomeningeal Metastases

7.5.1 Leptomeningeal Metastases Radiology

7.5.2 Leptomeningeal Metastases Histology

7.6 Conclusion

References

8 Treatment of Intradural Extramedullary Spinal Tumors

8.1 Surveillance

8.2 Radiographic Characteristics

8.3 Operative Management

8.3.1 Meningioma

8.3.2 Schwannoma and Neurofibroma

8.3.3 Filum Terminale Ependymoma

8.4 Radiation Therapy

8.5 Conclusion

References

9 Minimally Invasive Approaches to Intradural Extramedullary Tumors

9.1 Introduction

9.2 Patient Selection: Indications, Advantages, and Disadvantages

9.3 Preoperative Assessment and Planning

9.4 Surgical Technique

9.4.1 Positioning and Anesthesia

9.4.2 Exposure

9.4.3 Tumor Resection

9.4.4 Dural Closure

9.5 Postoperative Care and Concerns

9.6 Discussion

9.7 Conclusion

References

10 Intradural Extramedullary Spinal Cord Tumors: Current Research and Potential Therapeutics

10.1 Systemic Therapies for IDEM Spine Tumors in Neurofibromatosis

10.1.1 Introduction

10.1.2 NF1: Genetic Pathophysiology

10.1.3 NF1: Therapeutic Advances

10.1.4 NF2: Genetic Pathophysiology

10.1.5 NF2: Therapeutic Advances

10.2 Stereotactic Radiosurgery

10.2.1 Introduction

10.2.2 Recent Research of SRS Use in IDEM Tumors

10.2.3 Future Directions

10.3 Robot-Assisted Surgery

10.3.1 Introduction

10.3.2 Progress in Robot-Assisted Spine Tumor Surgery

10.3.3 Future Directions

10.4 Conclusion

References

Section III: Peripheral Nerve Tumors

11 Peripheral Nerve Tumor: Histopathology and Radiology

11.1 Neurofibroma

11.1.1 Pathologic/Anatomic Variants of Neurofibroma

11.1.2 Microscopic Pathology of Neurofibroma

11.1.3 Radiologic Features of Neurofibroma

11.2 Schwannoma

11.2.1 Conventional Schwannoma

11.2.2 Microscopic Pathology of Conventional Schwannoma

11.2.3 Cellular Schwannoma

11.2.4 Plexiform Schwannoma

11.2.5 Melanotic Schwannoma

11.2.6 Radiologic Features of Schwannoma

11.3 Perineurioma

11.4 Hybrid Nerve Sheath Tumors

11.5 Nerve Sheath Myxoma, Neurothekeoma, Ganglioneuroma, and Granular Cell Tumor

11.6 Malignant Peripheral Nerve Sheath Tumor

11.6.1 Radiologic Features of MPNST

11.7 Conclusion

References

12 Treatment of Peripheral Nerve and Paraspinal Tumors

12.1 Introduction

12.2 Presentation

12.3 Differential Diagnosis

12.4 Evaluation

12.4.1 History and Physical Examination

12.4.2 Radiographic Evaluation

12.5 Classification Systems

12.6 Neurophysiological Evaluation

12.7 Tissue Biopsy

12.8 Management

12.9 Surgical Approaches

12.9.1 Posterior Approaches

12.9.2 Posterolateral Approaches

12.9.3 Anterolateral Approaches

12.9.4 Minimally Invasive Surgical Approaches

12.10 Postoperative Management

12.11 Complications

12.11.1 Neurological Injury

12.11.2 Pleural Tear

12.12 Spinal Stability

12.13 Outcomes of Tumor Resection of Relevant Nerve Roots

12.14 Postoperative Adjuvant Therapy

12.15 Conclusion

References

13 Peripheral Nerve and Paraspinal Tumors: Future Directions of Therapy

13.1 Introduction

13.2 Chemotherapeutics

13.2.1 Signal Transduction Pathways Implicated in NF1 -Associated PNF and MPNST

13.2.2 Pharmacological Agents Targeting RAS

13.2.3 Pharmacological Agents Targeting the mTOR Cascade

13.2.4 Pharmacological Agents Targeting the MAPK Cascade

13.2.5 Pharmacological Agents Targeting Other Pathways

13.3 Targeted Chemotherapeutic Delivery Platforms

13.3.1 Interleukin-13 Receptor Alpha 2 (IL13Rα2) Targeted Drug Delivery System

13.3.2 Magnetic Targeting of Systemically Delivered Magnetic Nanoparticles (MNPs)

13.3.3 Polymer-Based Local Chemotherapeutic Delivery Platforms

13.4 Oncolytic Virus Therapy for PNSTs

13.5 Paraspinal and Peripheral Nerve Tumor Research Areas and Future Therapies in Radiotherapy

13.6 Conclusion

References

Index

 

An aparitie	17 Jan. 2022
Autor	Ankit I. Mehta
Dimensiuni	22.3 x 1.5 x 29 cm
Editura	Thieme
Format	Hardcover
ISBN	9781626239319
Limba	Engleza
Nr pag	150
Versiune digitala	DA