Prognosis and strategies for reoperation in recurrent spinal tumors: an average 5-Year follow-up retrospective study

Few studies have reported reoperation for recurrent spinal tumors. We aimed to investigate the long-term outcomes of reoperation for recurrent spinal tumors and determine the optimal surgical strategy.

We retrospectively reviewed 2000 benign spinal tumors at our center and collected patients who underwent reoperation for recurrence. Follow-up included assessment of neurological function, pain and spinal instability. Logistic regression was performed to identify prognostic factors. A web-based dynamic nomogram was constructed to quantify the risk of poor outcome.

Reoperation for recurrent tumors accounted for 4.1% of all spinal tumors surgeries. In this study, 94 patients who underwent reoperation were included. Long-term follow-up showed that reoperation resulted in good neurological outcomes in 72% of patients and pain improvement in 84% of patients. The recurrence rate after reoperation was 8.7%. During the reoperation, most patients (91%) did not undergo spinal internal fixation, and most patients (94%) had good spinal stability during the follow-up. We found that poor outcomes were significantly associated with longer duration of symptoms, thoracic location, longer tumor segments and meningioma. Favorable outcomes were strongly correlated with dumbbell-type tumor, complete resection, schwannoma, and good neurological function (MMS grade I/II). Regression analysis revealed that good neurological function at discharge was an independent prognostic factor. Finally, we established a preoperative nomogram to evaluate the prognosis of reoperation in recurrent tumors.

In patients with recurrent benign spinal tumors and progressive symptoms, reoperation may improve neurological function, though outcomes vary by tumor type and location. Clinicians can use the nomogram to predict the patient subgroups that are most likely to benefit from reoperation.