BACKGROUND Intramedullary tumors of the cervical spinal cord are commo
n and many believe they are amenable to an aggressive approach. Howeve
r, surgical removal of intramedullary tumors of the cervical spinal co
rd is still controversial because of the great risk of respiratory dys
function or quadriplegia or both upon resection of the tumor. METHODS
We present a consecutive series of 58 patients who underwent surgical
treatment for intramedullary tumors of the cervical spinal cord. Surgi
cal results are analyzed to refine our indications for surgery and its
timing. The roles of preoperative radiotherapy and posttherapeutic co
rd appearance and function are discussed. RESULTS Tumors were totally
resected in 50 (86.2%), subtotally in seven and partially in one patie
nt. Forty-five (77.6%) patients had improved neurologic status postope
ratively. Intramedullary tumors in the cervical area have better resul
ts from surgery than intramedullary tumors in other levels of the spin
e. Patients with moderate neurologic deficits can recover remarkably w
ell after total tumor removal. Laser surgery is especially helpful for
lipoma. Preoperative radiotherapy should be avoided because it is ass
ociated with difficult surgery and poor clinical outcome. The thin spi
nal cord can function surprisingly well. CONCLUSIONS We conclude that
intramedullary tumors of the cervical spinal cord are amenable to tota
l surgical removal. Surgery is suitable when a patient presents with a
moderate neurologic deficit. Proficient surgical technique for total
tumor resection is necessary for good results. Preoperative radiothera
py contributes to difficult surgery and poor prognosis, and is not rec
ommended.