Surgical Management and Outcomes of Intradural Spinal Metastases

Ozoner B., Alioglu H., Osama M., Kus Silav Z., Bozkurt B.

World Neurosurgery, cilt.206, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 206
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.wneu.2025.124773
  • Dergi Adı: World Neurosurgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Index Islamicus, MEDLINE
  • Anahtar Kelimeler: Gross total resection, Intradural spinal metastases, Intramedullary metastasis, Neurological outcome, Spinal surgery, Survival analysis
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Background: Intradural spinal metastases are rare but clinically significant manifestations of systemic malignancies. Their management remains controversial, and evidence guiding surgical outcomes is limited. The aim of recent study is to evaluate the clinical features, surgical outcomes, and prognostic factors with intradural spinal metastases treated surgically at a single center. Methods: A retrospective review of 14 patients who underwent surgical resection for intradural extra- or intramedullary spinal metastases between 2014 and 2025 was conducted. Neurological outcomes were assessed using the McCormick scale. Overall survival and postoperative survival were analyzed using Kaplan–Meier and Cox regression models. Results: Lung cancer was the predominant primary tumor (80%), with thoracic spine being the most involved site (64.3%). Gross total resection (GTR) was achieved in 71.4% of the cases. Neurological function improved in 28.6% of the cases, remained stable in 42.9%, and worsened in the 28.6% postoperatively. Median postoperative survival was 9.5 months, and overall survival from primary diagnosis was 31.8 months. Subtotal resection and intramedullary involvement were associated with worse outcomes, though not statistically significant. Conclusions: Surgical resection of intradural spinal metastases can offer meaningful neurological improvement and symptom relief in selected patients. GTR is associated with better outcomes, and careful preoperative selection is critical. Multidisciplinary approaches remain essential for optimizing patient care.