Spinal hemangioblastomas: analysis of surgical outcome and prognostic factors View Full Text


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Article Info

DATE

2021-11-25

AUTHORS

Alberto Feletti, Alessandro Boaro, Davide Giampiccolo, Giorgio Casoli, Fabio Moscolo, Massimiliano Ferrara, Francesco Sala, Giacomo Pavesi

ABSTRACT

The prognostic factors for surgically removed spinal hemangioblastomas, the impact of VHL disease on outcome, and the role of intraoperative neuromonitoring are still not completely clear. The aim of this study was to review our experience with spinal hemangioblastomas in order to assess potential predictors of neurological outcome after surgery. All cases of spinal hemangioblastomas removed at two Italian academic institutions from 1985 to 2020 were reviewed. Data about clinical presentation and symptom duration, diagnosis of VHL, surgical approach, use of IONM, duration of hospital stay, follow-up, and modified McCormick grade before and after surgery were extracted. Sixty-one patients (31 F, 30 M) underwent 69 surgeries to remove 74 spinal hemangioblastomas (37 cervical, 32 thoracic, 5 lumbar). Improvement was found in 32.3% of cases, neurological condition remained stable in 51.6% of cases, and deteriorated in 16.1% of patients. A worsening trend in VHL patients and an improvement trend in non-VHL patients were detected, despite the lack of statistical significance. Laminotomy and use of IONM were found to be associated with better outcome, although no association was found between surgery without IONM and worse outcome. In most cases, patients affected by spinal hemangioblastomas can expect a good long-term outcome. In our experience, laminotomy seems to be associated with better outcome compared to laminectomy. While its absence is not associated with worse outcome, IONM seems to be associated with a better neurological outcome. Our study suggests that the more impaired the preoperative neurological condition, the worse the outcome. More... »

PAGES

1645-1661

References to SciGraph publications

  • 2019-05-14. Sporadic and Von-Hippel Lindau disease-associated spinal hemangioblastomas: institutional experience on their similarities and differences in JOURNAL OF NEURO-ONCOLOGY
  • 2009-05-09. Results of microsurgical treatment of medulla oblongata and spinal cord hemangioblastomas: a comparison of two distinct clinical patient groups in JOURNAL OF NEURO-ONCOLOGY
  • 2018-08-31. Long-term outcome and prognostic factors of intramedullary spinal hemangioblastomas in NEUROSURGICAL REVIEW
  • 2008-04-04. Intramedullary hemangioblastomas: timing of surgery, microsurgical technique and follow-up in 23 patients in EUROPEAN SPINE JOURNAL
  • 2014-12-15. Management and outcome in adult intramedullary spinal cord tumours: a 20-year single institution experience in BMC RESEARCH NOTES
  • 2000-05. Hemangioblastomas and Other Uncommon Intramedullary Tumors in JOURNAL OF NEURO-ONCOLOGY
  • 2015-07-05. Current Management and Treatment Modalities for Intramedullary Spinal Cord Tumors in CURRENT TREATMENT OPTIONS IN ONCOLOGY
  • 2005-12-21. Surgical treatment of hemangioblastomas of the central nervous system in pediatric patients in CHILD'S NERVOUS SYSTEM
  • 2016-02-23. Diagnosis and microsurgical treatment of spinal hemangioblastoma in NEUROLOGICAL SCIENCES
  • 2003-01. Spinal Cord Hemangioblastoma: Surgical Strategy and Clinical Outcome in JOURNAL OF NEURO-ONCOLOGY
  • 2008-02-07. Surgical management of spinal cord haemangioblastoma in ACTA NEUROCHIRURGICA
  • 2008-11-25. Spinal cord hemangioblastomas in von Hippel–Lindau disease in SPINAL CORD
  • 2007-07-26. Surgery for intramedullary spinal cord tumors: the role of intraoperative (neurophysiological) monitoring in EUROPEAN SPINE JOURNAL
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    http://scigraph.springernature.com/pub.10.1007/s10143-021-01696-x

    DOI

    http://dx.doi.org/10.1007/s10143-021-01696-x

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34825301


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    28 schema:description The prognostic factors for surgically removed spinal hemangioblastomas, the impact of VHL disease on outcome, and the role of intraoperative neuromonitoring are still not completely clear. The aim of this study was to review our experience with spinal hemangioblastomas in order to assess potential predictors of neurological outcome after surgery. All cases of spinal hemangioblastomas removed at two Italian academic institutions from 1985 to 2020 were reviewed. Data about clinical presentation and symptom duration, diagnosis of VHL, surgical approach, use of IONM, duration of hospital stay, follow-up, and modified McCormick grade before and after surgery were extracted. Sixty-one patients (31 F, 30 M) underwent 69 surgeries to remove 74 spinal hemangioblastomas (37 cervical, 32 thoracic, 5 lumbar). Improvement was found in 32.3% of cases, neurological condition remained stable in 51.6% of cases, and deteriorated in 16.1% of patients. A worsening trend in VHL patients and an improvement trend in non-VHL patients were detected, despite the lack of statistical significance. Laminotomy and use of IONM were found to be associated with better outcome, although no association was found between surgery without IONM and worse outcome. In most cases, patients affected by spinal hemangioblastomas can expect a good long-term outcome. In our experience, laminotomy seems to be associated with better outcome compared to laminectomy. While its absence is not associated with worse outcome, IONM seems to be associated with a better neurological outcome. Our study suggests that the more impaired the preoperative neurological condition, the worse the outcome.
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