Desheng Kong, Neurosurgeon at Peking University International Hospital in Beijing, China, shared on X:
“The first irreversible injury in intramedullary tumor surgery often comes from traction, not cutting.
A tumor can look well circumscribed yet still transmit force through a few intact adhesions, vessels, or pial attachments, deforming normal cord before the dissection itself becomes obviously dangerous.
The safer sequence is to create mobility first – release the poles, define the circumferential plane, protect feeding and draining vessels – then let the tumor come to you. A “good plane” is not truly safe until the mass moves independently of the cord.”
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