The current management of spinal cord cavernoma

Area of Science:

• Neurosurgery
• Neurology
• Spinal Surgery

Background:

• Spinal cavernous malformations (SCM) were historically considered rare but are now more frequently identified due to advanced imaging.
• The increasing incidence necessitates a better understanding of SCM management strategies.
• Limited data exists on the treatment and follow-up of SCM.

Purpose of the Study:

• To review clinical features and outcomes of SCM management.
• To compare surgical versus conservative treatment approaches for SCM.
• To analyze current literature on SCM imaging, surgical techniques, and natural history.

Main Methods:

• Retrospective review of 29 SCM patients treated between 2006-2016.
• Systematic literature search on SCM management.
• Analysis of imaging techniques, surgical approaches, and natural history.

Main Results:

• SCM diagnosed in 7.1% of cavernous malformation patients (29/406).
• Most diagnoses (90%) occurred after symptom onset, with cervical and thoracic localizations being most common.
• Surgical resection improved function in 62.5% of patients, while conservative management showed improvement in 25%.

Conclusions:

• Gross-total resection is the definitive treatment for symptomatic SCM.
• Unilateral hemilaminectomy for SCM offers good outcomes with acceptable risks.
• Conservative management is suitable for asymptomatic, elderly, or stable mild SCM cases.