دورية أكاديمية
Residual and Recurrent Spinal Cord Cavernous Malformations: Outcomes and Techniques to Optimize Resection and a Systematic Review of the Literature
| العنوان: | Residual and Recurrent Spinal Cord Cavernous Malformations: Outcomes and Techniques to Optimize Resection and a Systematic Review of the Literature |
|---|---|
| المؤلفون: | Srinivasan, Visish M, Karahalios, Katherine, Shlobin, Nathan A, Koester, Stefan W, Nguyen, Candice L, Rumalla, Kavelin, Rahmani, Redi, Catapano, Joshua S, Labib, Mohamed A, Mitha, Alim P, Spetzler, Robert F, Lawton, Michael T |
| المصدر: | Neurosurgery |
| بيانات النشر: | Barrow - St. Joseph's Scholarly Commons |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Male, Humans, Female, Adolescent, Young Adult, Adult, Middle Aged, Aged, Retrospective Studies, Treatment Outcome, Hemangioma, Cavernous, Central Nervous System (diagnostic imaging, surgery), Neurosurgical Procedures (methods), Spinal Cord (diagnostic imaging |
| الوصف: | BACKGROUND: Intramedullary spinal cord cavernous malformations (SCCMs) account for only 5% of overall cavernous malformations (CMs). The occurrence of recurrent or residual SCCMs has not been well discussed, nor have the technical nuances of resection. OBJECTIVE: To assess the characteristics of residual SCCMs and surgical outcomes and describe the techniques to avoid leaving lesion remnants during primary resection. METHODS: Demographic, radiologic, intraoperative findings and surgical outcomes data for a cohort of surgically managed intramedullary SCCMs were obtained from an institutional database and retrospectively analyzed. A systematic literature review was performed using PRISMA guidelines. RESULTS: Of 146 SCCM resections identified, 17 were for residual lesions (12%). Patients with residuals included 13 men and 4 women, with a mean age of 43 years (range 16-70). All patients with residual SCCMs had symptomatic presentations: sensory deficits, paraparesis, spasticity, and pain. Residuals occurred between 3 and 264 months after initial resection. Approaches for 136 cases included posterior midline myelotomy (28.7%, n = 39), pial surface entry (37.5%, n = 51), dorsal root entry zone (27.9%, n = 38), and lateral entry (5.9%, n = 8). Follow-up outcomes were similar for patients with primary and residual lesions, with the majority having no change in modified Rankin Scale score (63% [59/93] vs 75% [9/12], respectively, P = .98). CONCLUSION: SCCMs may cause significant symptoms. During primary resection, care should be taken to avoid leaving residual lesion remnants, which can lead to future hemorrhagic events and neurological morbidity. However, satisfactory results are achievable even with secondary or tertiary resections. |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://scholar.barrowneuro.org/neurosurgery/1833Test; https://doi.org/10.1227/ons.0000000000000456Test |
| DOI: | 10.1227/ons.0000000000000456 |
| الإتاحة: | https://doi.org/10.1227/ons.0000000000000456Test https://scholar.barrowneuro.org/neurosurgery/1833Test |
| رقم الانضمام: | edsbas.DC8BD465 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1227/ons.0000000000000456 |
|---|