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[Factors affecting the outcome of surgical management for extramedullary spinal cord tumors: a multicenter study]
V A Byval'tsev1, V A Sorokovikov2, B B Damdinov3
1Nauchnyĭ tsentr rekonstruktivnoĭ i vosstanovitel'noĭ khirurgii SO RAMN, Irkutsk; Irkutskiĭ gosudarstvennyĭ meditsinskiĭ universitet; Irkutskaia gosudarstvennaia meditsinskaia akademiia poslediplomnogo obrazovaniia; Dorozhnaia klinicheskaia bol'nitsa na st. Irkutsk-Passazhirskiĭ OAO "RZhD".
Unlabelled:
Extramedullary spinal cord tumors (ESCTs) are relatively rare neoplasms requiring surgical treatment. This paper presents a study of outcomes in patients with ESCTs treated at Irkutsk region hospitals with different facilities.
Aim:
To identify factors affecting the outcome of surgical treatment of ESCTs.
Material And Methods:
The disease stage before surgery was evaluated according to the I.Ya. Razdol'skiy and McCormick classifications. Features and extension of the approach, the extent of blood loss, surgery duration, and the equipment used were analyzed. Treatment outcomes were assessed according to the MacNub and McCormick neurological outcome scales.
Results:
ESCTs were removed totally in 84 (95%) patients and subtotally in 4 (5%). Tumor recurrence was detected in 8 patients. No deaths were observed. No correlation was found between the treatment outcome, according to the McCormick scale, and factors such as gender, tumor location, histological type, tumor grade, disease duration, and type of a surgical approach and the equipment used. Factors having medium and high correlations with the disease outcome are a neurological disease phase and an initial neurological deficit: sensory deficit, r=0.32; motor deficit, r=0.33; pelvic disturbances, r=0.35; McCormick grade before surgery, r=0.74; disease phase r=0.41 (p<0.05).
Conclusion:
The disease phase is the most significant factor affecting the outcome of surgical treatment in patients with ESCTs. Despite this, important aspects of surgical treatment of ESCT include the approach that is adequate to the tumor size and localization, as well as combination of different surgical techniques.
