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Open Access 16-03-2023 | Original Article

Functional neurological outcome of spinal cavernous malformation surgery

Authors: Laurèl Rauschenbach, Alejandro N. Santos, Adrian Engel, Angelina Olbrich, Arnau Benet, Yen Li, Börge Schmidt, Oliver Gembruch, Neriman Özkan, Ramazan Jabbarli, Karsten H. Wrede, Adrian Siegel, Michael T. Lawton, Ulrich Sure, Philipp Dammann

Published in: European Spine Journal | Issue 5/2023

Abstract

Purpose

Spinal cavernous malformations (SCM) present a risk for intramedullary hemorrhage (IMH), which can cause severe neurologic deficits. Patient selection and time of surgery have not been clearly defined.

Methods

This observational study included SCM patients who underwent surgery in our department between 2003 and 2021. Inclusion required baseline clinical factors, magnetic resonance imaging studies, and follow-up examination. Functional outcome was assessed using the Modified McCormick scale score.

Results

Thirty-five patients met the inclusion criteria. The mean age was 44.7 ± 14.5 years, and 60% of the patients were male. In univariate analysis, the unfavorable outcome was significantly associated with multiple bleeding events (p = .031), ventral location of the SCM (p = .046), and incomplete resection (p = .028). The time between IMH and surgery correlated with postoperative outcomes (p = .004), and early surgery within 3 months from IMH was associated with favorable outcomes (p = .033). This association remained significant in multivariate logistic regression analysis (p = .041).

Conclusions

Removal of symptomatic SCM should be performed within 3 months after IMH when gross total resection is feasible. Patients with ventrally located lesions might be at increased risk for postoperative deficits.

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Title: Functional neurological outcome of spinal cavernous malformation surgery
Authors: Laurèl Rauschenbach
Alejandro N. Santos
Adrian Engel
Angelina Olbrich
Arnau Benet
Yen Li
Börge Schmidt
Oliver Gembruch
Neriman Özkan
Ramazan Jabbarli
Karsten H. Wrede
Adrian Siegel
Michael T. Lawton
Ulrich Sure
Philipp Dammann
Publication date: 16-03-2023
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2023
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07640-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Functional neurological outcome of spinal cavernous malformation surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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