Hohenberger, Christoph and Hinterleitner, Julia and Schmidt, Nils-Ole and Doenitz, Christian and Zeman, Florian and Schebesch, Karl-Michael (2020) Neurological outcome after resection of spinal schwannoma. CLINICAL NEUROLOGY AND NEUROSURGERY, 198: 106127. ISSN 0303-8467, 1872-6968
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Introduction: Spinal schwannoma (SS) is the most frequently diagnosed benign spinal tumor, constituting approximately 25 % of all intradural tumors. Aim of our study was to identify factors that potentially affect immediate postoperative neurological outcome, and the rate of functional recovery within 12 months. Methods: Screening of our institutional database yielded 90 consecutive patients (mean age 57.1 years, 39 women [43.3 %]) with newly diagnosed SS between March 1997 and October 2018. We pre- and postoperatively reviewed patient charts, surgical reports, radiographic data, use of IOM, duration of symptoms, histopathology, co-morbidities, radiographic extension, surgical strategy, neurological performance (Japanese Orthopedic Association Score [JOA score] and Frankel Grade Classification). Results: Mean duration of preoperative symptoms was 3.6 +/- 1.6 months. Most common symptoms were local pain (n = 77, 85.6 %). Macroscopic complete resection was achieved in 84 patients (93.3 %). During follow-up, complete recovery from local pain was documented for 41 patients (59.7 %), from radiating pain for 41 (69.5 %; p < 0.001). Postoperatively, 25 (27.7 %) patients developed a new neurological deficit (motor deficits n = 3 and sensory deficits n = 23; one patient developed both); after 12 months, however, motor deficits had abated in all patients, and 16 (69.5 %) patients had completely recovered from sensory deficits. Use of intraoperative monitoring (IOM) was a significant predictor for good functional outcome (p < 0.001). Conclusion: Resection of SS accompanied by IOM whenever feasible should be advocated. We achieved a high number of complete resections with a low rate of morbidity. New postoperative motor or sensory deficits had a very high rate of complete recovery within 12 months.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TUMORS; MANAGEMENT; INDEX; Benign spinal tumors; Spinal schwannoma; Spinal neurinoma; Spinal surgery; Spinal neuro-oncology; Functional outcome; Neurosurgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 08 Mar 2021 09:40 |
| Last Modified: | 08 Mar 2021 09:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/43441 |
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