Spinal astrocytoma

Spinal astrocytoma is a tumor that often occurs in the human spine. Spinal astrocytoma may occur in every joint of the spine. Patients with spinal astrocytomas may experience severe damage to their spine and compression of their spinal nerves. In addition, spinal astrocytomas have the potential to expand, and some may spread to other joints of the spine. So, what should we do about spinal astrocytoma?

1. Concept

Among the intramedullary tumors in the spinal canal, the most common is ependymoma, followed by spinal astrocytoma, which accounts for about 30% of intramedullary tumors. Spinal astrocytoma can occur in any segment of the spinal cord, but is most common in the thoracic segment, followed by the cervical segment. Spinal astrocytoma originates from spinal astrocytes and grows infiltratively along the longitudinal axis of the spinal cord with no obvious boundary with the spinal cord tissue. The tumor is a spindle-shaped swelling that may involve several spinal cord segments, and syringomyelia may be seen in the segments adjacent to the tumor. Two common tissue types are found under microscopic examination: fibrous astrocytes and protoplasmic astrocytes. Most of them are low-grade malignant tumors of grade I to II, which may grow in an invasive manner or undergo cystic changes.

2. Age group prone to onset

Spinal astrocytoma is common in people aged 30 to 60 years old, mostly in women. Among the patients, 75% had astrocytomas of lower malignancy (the tumors were generally small, without capsules, and unclear boundaries); 38% had cystic changes in their tumors, with high levels of cystic fluid protein. MRI shows that the spinal cord is thickened at the tumor site, the tumor signal may be higher than that of the adjacent spinal cord, and the boundary is unclear. Cysts may also be present at the head and tail of the lesion.

3. Early symptoms

Patients with spinal astrocytoma have slow tumor growth, a long course of disease, and no obvious early symptoms. The symptoms are mostly numbness and weakness of the lower limbs at the tumor site, and radicular pain is rare. The patient's sensory impairment develops from top to bottom, the sensory plane is not obvious, and sensory dissociation may occur. Sphincter and autonomic dysfunction such as nutritional disorders appear early and are prone to bedsores in the late stages. If the tumor becomes cystic, the condition may suddenly worsen and paralysis may occur.

4. Treatment

The tumor of patients with spinal astrocytoma grows in an invasive manner, so it is difficult to remove it completely. For extensive lesions in the high cervical segment, surgery should be performed with caution. After tumor resection, the dura mater is generally not sutured to provide adequate decompression; postoperative radiotherapy is recommended for high-grade astrocytomas. The prognosis of astrocytoma is generally worse than that of ependymoma, and about half of patients will have tumor recurrence within 4 to 5 years after surgery.