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- Title
Functional neurological outcome of spinal cavernous malformation surgery.
- Authors
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; Dammann, Philipp
- 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.
- Subjects
MAGNETIC resonance imaging; LOGISTIC regression analysis; HUMAN abnormalities; SPINAL surgery; PATIENT selection; SURGERY
- Publication
European Spine Journal, 2023, Vol 32, Issue 5, p1714
- ISSN
0940-6719
- Publication type
Article
- DOI
10.1007/s00586-023-07640-5