{"id":"9e509d9c-9fdb-49cb-8b95-1e4495f2ca77","slug":"a-systematic-review-of-the-utility-of-5-aminolevulinic-acid-induced-fluorescence-in-spine-tumor-surgery","title":"A systematic review of the utility of 5-aminolevulinic acid-induced fluorescence in spine tumor surgery","authors":["Thamer Alsharif","Alaa Turkistani","Badr Hafiz","Amin Gronfula","Adel Alsulami","Abdulaziz Aldahlawi","Mohammed Aref"],"abstract":"Background: 5-aminolevulinic acid (5-ALA)-induced fluorescence is well established in intracranial glioma surgery, aiding tumor visualization and extent of resection. This systematic review evaluates the utility of 5-ALA in spinal tumor surgery, focusing on fluorescence characteristics, resection outcomes, and perioperative safety. Methods: A systematic literature search was performed in Embase, Web of Science, PubMed, and MEDLINE databases; 13 studies met the inclusion criteria. Eligible studies involved human subjects undergoing spinal tumor surgery with intraoperative use of 5-ALA for tumor fluorescence. Primary outcomes assessed included fluorescence response and extent of resection; secondary outcomes included postoperative neurological status and adverse effects. Results: Thirteen studies involved 245 patients whose tumor diagnoses included ependymomas, meningiomas, astrocytomas, neurinomas, and metastatic lesions. Fluorescence rates varied by tumor type; uptake showed high positivity in ependymomas and meningiomas, but inconsistent findings for astrocytomas and metastases. Gross total resection was achieved more frequently in well-circumscribed benign tumors. Although patients experienced favorable postoperative outcomes, transient or persistent neurological deficits occurred in a subset of patients depending on tumor location and surgical complexity. Standard dosing (20 mg/kg preoperatively) was consistent across studies, and adverse effects were limited to expected photosensitivity. Conclusion: 5-ALA enhances intraoperative visualization and may facilitate more complete resection of selected spinal tumors, particularly ependymomas and meningiomas.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/9e509d9c-9fdb-49cb-8b95-1e4495f2ca77/featured/hero-1781557834927.png","publishDate":"2026-03-06T00:00:00.000Z","doi":"10.25259/SNI_46_2026","categories":["Spine","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/03/14354/SNI-17-131.pdf"}