Functional neurological outcome of spinal cavernous malformation surgery

Authors

• Laurèl Rauschenbach, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany. laurel.rauschenbach@uk-essen.de.
• Alejandro N. Santos, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Adrian Engel, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Angelina Olbrich, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Arnau Benet, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.Follow
• Yen Li, Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
• Börge Schmidt, Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
• Oliver Gembruch, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Neriman Özkan, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Ramazan Jabbarli, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Karsten H. Wrede, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Adrian Siegel, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
• Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA.Follow
• Ulrich Sure, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
• Philipp Dammann, Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.

Document Type

Article

Abstract

PURPOSE: Spinal cavernous malformations (SCM) present a risk for intramedullary hemorrhage (IMH), which can cause severe neurologic deficits. Patient selection and time of surgery have not been clearly defined. METHODS: This observational study included SCM patients who underwent surgery in our department between 2003 and 2021. Inclusion required baseline clinical factors, magnetic resonance imaging studies, and follow-up examination. Functional outcome was assessed using the Modified McCormick scale score. RESULTS: Thirty-five patients met the inclusion criteria. The mean age was 44.7 ± 14.5 years, and 60% of the patients were male. In univariate analysis, the unfavorable outcome was significantly associated with multiple bleeding events (p = .031), ventral location of the SCM (p = .046), and incomplete resection (p = .028). The time between IMH and surgery correlated with postoperative outcomes (p = .004), and early surgery within 3 months from IMH was associated with favorable outcomes (p = .033). This association remained significant in multivariate logistic regression analysis (p = .041). CONCLUSIONS: Removal of symptomatic SCM should be performed within 3 months after IMH when gross total resection is feasible. Patients with ventrally located lesions might be at increased risk for postoperative deficits.

Medical Subject Headings

Humans; Male; Adult; Middle Aged; Female; Treatment Outcome; Retrospective Studies; Neurosurgical Procedures (adverse effects, methods); Musculoskeletal Abnormalities; Magnetic Resonance Imaging; Spinal Cord Neoplasms (surgery)

Publication Date

5-1-2023

Publication Title

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

E-ISSN

1432-0932

Volume

32

Issue

5

First Page

1714

Last Page

1720

PubMed ID

36928489

Digital Object Identifier (DOI)

10.1007/s00586-023-07640-5

Recommended Citation

Rauschenbach, Laurèl; Santos, Alejandro N.; Engel, Adrian; Olbrich, Angelina; Benet, Arnau; Li, Yen; Schmidt, Börge; Gembruch, Oliver; Özkan, Neriman; Jabbarli, Ramazan; Wrede, Karsten H.; Siegel, Adrian; Lawton, Michael T.; Sure, Ulrich; and Dammann, Philipp, "Functional neurological outcome of spinal cavernous malformation surgery" (2023). Neurosurgery. 1799.
https://scholar.barrowneuro.org/neurosurgery/1799