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Observational Study
. 2023 May;32(5):1714-1720.
doi: 10.1007/s00586-023-07640-5. Epub 2023 Mar 16.

Functional neurological outcome of spinal cavernous malformation surgery

Laurèl Rauschenbach  1   2 , Alejandro N Santos  3   4 , Adrian Engel  3   4 , Angelina Olbrich  3   4 , Arnau Benet  3   5 , Yen Li  6 , Börge Schmidt  7 , Oliver Gembruch  3   4 , Neriman Özkan  3   4 , Ramazan Jabbarli  3   4 , Karsten H Wrede  3   4 , Adrian Siegel  8 , Michael T Lawton  5 , Ulrich Sure  3   4 , Philipp Dammann  3   4
Affiliations
Observational Study

Functional neurological outcome of spinal cavernous malformation surgery

Laurèl Rauschenbach et al. Eur Spine J. 2023 May.

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.

Keywords: Cavernous angioma; Cavernous malformations of the spinal cord; Outcome; Spinal cord; Surgery.

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