Does the presence or absence of preoperative lower extremity neurologic symptoms influence postoperative clinical outcome in patients with cervical intradural extramedullary tumors?: a single-center retrospective comparative study

Abstract

Study design: Retrospective comparative study OBJECTIVES: To investigate whether the presence or absence of preoperative lower extremities neurological symptoms (LENS) influences clinical outcomes following tumor resection in patients with cervical intradural extramedullary (IDEM) tumors.

Setting: The single institution in Japan.

Methods: Ninety-two patients with cervical IDEM tumors requiring surgical resection were included. Based on the degree of preoperative LENS assessed using the modified McCormick scale (MMCS), patients were categorized into LENS (-) and (+) groups. Demographic and surgical characteristics were compared between both groups.

Results: There were no significant differences observed in sex, tumor location, tumor size, surgical time, estimated blood loss, approach for tumorectomy, or tumor histopathology between the two groups. Additionally, the overall surgical outcomes were favorable for both groups. At the final follow-up, 91.1% of the patients in the LENS (+) group were able to walk without support. Improvement in LENS was observed after surgery in most patients with preoperative MMCS II-IV, but it persisted in approximately 40% of patients with preoperative MMCS V. In the LENS (+) group, there were no significant differences in demographic or surgical data between the patients with MMCS I and II-III at the final follow-up.

Conclusions: Regardless of the presence or absence of preoperative LENS, clinical improvement was observed after tumor resection in most patients with cervical IDEM tumors. These findings suggest that neurological status is likely to improve sufficiently if tumor resection is performed before preoperative LENS deteriorates to an extremely severe stage as MMCS V.