Romanian Neurosurgery (Mar 2016)
Chordomas, malignant spinal tumors
Abstract
Objective: Spinal chordomas are rare, locally invasive, malignant neoplasm, representing 5% of all malignant tumors of the skeleton. In the majority of cases the segment involved is the sacrum. This study reviews our experience during the last 15 years at The Spinal Surgery Department of “Bagdasar-Arseni” Clinical Hospital, to determine the effects of various treatment methods on the overall course of this disease process. Methods: A retrospective study was performed, from 2000 to 2015, in which, 31 patients with spinal chordomas were evaluated at our institution. Results: Two thirds of patients were male, with a mean age of 57 years. Patients presented with local pain, radiculopathy and bladder-bowel dysfunction at hospital admission. There were 24 patients with sacral chordomas, 4 with cervical chordomas, 2 with thoracic and one with lumbar chordoma. Al patients underwent at least one surgical procedure. The main goal of surgery was to achieve total resection of the tumor. Conclusion: Our study suggests that spinal chordomas are rare tumors with a high risk of tumor recurrence. If total resection is achieved, the risk of recurrence diminishes. If the tumor resection is subtotal, than recurrence appears in all cases. After tumor resection, the surgeon faces the problem of spinal instability that needs solving. Based on these findings, we think that, whenever possible, radical resection should be the treatment of choice for spinal chordomas.
