Long-term surgical outcomes and prognosis of cervical spinal hemangioblastomas

Hemangioblastomas (HBs) occurring in the cervical spinal region are infrequently reported. Surgical resection of cervical HBs poses a significant challenge, and the long-term therapeutic outcomes remain unclear.

A comprehensive retrospective analysis was conducted to review the treatment outcomes of patients with cervical HBs from 2011 to 2021. Patients with detailed preoperative clinical and radiological information, as well as follow-up data, were included in this study.

One hundred six adult patients were enrolled, with a mean age of 37.4 ± 15.6 years (range: 18-68 years), and a male predominance of 58.5 %. Thirty-two patients (30.2 %) had von Hippel-Lindau (VHL) disease. VHL-associated patients were younger (p = 0.023), had a shorter duration of symptoms (p = 0.004), and had smaller lesion size (p = 0.039) compared to the sporadic group. Fourteen patients (13.2 %) experienced immediate postoperative deterioration. During long-term follow-up, 35 patients (33.0 %) improved, 57 patients (53.8 %) remained stable. 8 patients (7.5 %) worsened compared to baseline, and 6 patients (5.7 %) died. A recurrent HBs (p = 0.027), ventral location (p = 0.046), and worsened immediately after surgery (p = 0.001) were statistically significant indicators for unfavorable outcomes in multivariate analysis.

Surgical resection of cervical spinal HBs can achieve favorable long-term outcomes in most cases, although neurological deterioration may occur immediately after surgery. Postoperative deficits occur in 13.2 % patients, and the incidence of respiratory insufficiency is relatively low. A recurrent HBs, ventral location, and worsened immediately after surgery were indicators for unfavorable outcomes.