ORIGINAL ARTICLE
Central neuropathic pain after surgical resection in patients with spinal intramedullary tumor

https://doi.org/10.1007/s00776-012-0236-6Get rights and content

Abstract

Study design

Retrospective case series.

Objective

To examine central neuropathic pain after surgical resection of intramedullary spinal cord tumor (IMSCT).

Summary of background data

Because of the rarity of IMSCT, there is little information about postoperative neuropathic pain after surgical resection.

Methods

Eighty-five of 105 patients treated surgically for IMSCT at our hospital between 2000 and 2008 completed the Neuropathic Pain Symptom Inventory (NPSI) and the short form (SF)-36 health inventory. The NPSI score was analyzed against the tumor type and the postoperative Japanese Orthopaedic Association (JOA) score for neurological symptoms.

Results

The mean NPSI score of the patients was 13.5. The subscore for paresthesia/dysesthesia was significantly higher than the other subscores. Analysis of the NPSI scores by tumor type revealed no significant differences among patients with ependymoma, astrocytoma, and vascular tumors. The postoperative JOA score showed a weak negative correlation with the NPSI score in patients with thoracic spinal cord tumor, and no correlation in those with cervical tumor. In the 11 patients with hemangioblastoma, intense pain was reported at the level of the tumor, although postoperative paralysis was mild. All the postoperative SF-36 subscores of our study patients were significantly lower than the national average, and a significant negative correlation was observed between the SF-36 and the NPSI subscores.

Conclusion

Neuropathic pain after surgical resection reduces the QOL of patients with IMSCTs, and pain severity varies with the tumor's location and histological features, the severity of paralysis, and the location of pain relative to the tumor.

References (19)

There are more references available in the full text version of this article.

Cited by (22)

  • Spinal Hemangioblastomas and Neuropathic Pain

    2021, World Neurosurgery
    Citation Excerpt :

    The major fibers go to the thalamus via the spinothalamic tract (mostly contralateral and less often ipsilaterally) and then to the sensory cortex.29 When this neuroanatomic structure is considered, it can be seen that SHs, generally located close to the DREZ, sometimes lead to NP by a syrinx affecting this system.1,2,4,5,7-9,16,18,27,31 However, as preoperative NP was seen in only 1 patient in this study, the current study is not able to explain the causes affecting preoperative NP.

  • Health-Related Quality of Life After Microscopic Total Removal of Spinal Intramedullary Ependymomas in a Single-Institute 3-Year Prospective Study

    2020, World Neurosurgery
    Citation Excerpt :

    Although several clinical studies have suggested the benefits of surgery for spinal intramedullary ependymoma, little evidence has been accumulated regarding HRQOL outcomes. Nakamura et al.19 retrospectively examined 85 of 105 patients treated surgically for spinal intramedullary tumors. They focused on neuropathic pain after surgical resection and demonstrated that neuropathic pain after surgical resection reduced patient quality of life (QOL), and pain severity varied with tumor location and histologic features, severity of paralysis, and location of pain relative to the tumor.

View all citing articles on Scopus

The authors declare no conflict of interest.

View full text