LONG-TERM RESULTS OF SURGICAL TREATMENT IN PATIENTS WITH INTRADURAL SPINAL TUMORS

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Abstract

Background: Intradural spinal cord tumors include extramedullary and intramedullary tumors. The search for literature sources in the Pubmed, Medline, and E-Library databases detected a little number of researches on the long-term results of the surgical treatment of intradural spinal cord tumors. These clinical series include a small number of patients and do not consider the factors influencing clinical outcomes of surgical treatment.

Aim: To evaluate the long-term results of surgical treatment in patients with intradural spinal cord tumors, to identify the main factors influencing the clinical and neurological outcomes of surgical interventions in this group of patients.

Materials and methods: The study included 277 medical records of 244 patients with intradural extramedullary and 33 patients with intradural intramedullary tumors of the spinal cord. Clinical-neurological outcomes of surgical treatment in patients with intradural spinal cord tumors and factors influencing the outcomes were analyzed.

Results: When comparing the degree of neurologic deficit in patients with intradural extramedullary tumors prior to surgery, no significant differences were found (p=0.241) both in the early postoperative period and 6 months after the surgery. Nevertheless, when comparing these indicators in a period of 12, 24, 36, 48, and 60 months after the surgery, statistically significant differences were revealed (p<0.001). There was no statistically significant difference (p=0.437) between the scores in patients with intramedullary tumors on the modified McCormick Scale preoperatively, at the 6-month and one-year follow-up; however, comparison of the clinical and neurological indicators at 24, 26, 48, and 60 months revealed a significant difference (p<0.001). The surgery outcomes in considered groups of patients were significantly influenced by the following indicators: the ASA risk level (odds ratio (OS) 2.138; 95% confidence interval (95% CI) 3.346–12.145) and intraoperative neurophysiological monitoring (OR 2.84; 95% CI 1.67–9.56).

Conclusion: The study registered good and excellent long-term outcomes in most cases of intradural spinal cord tumors when the maximum possible tumor excision was performed. Analysis of the influence of various factors on the clinical and neurological outcomes in the study group of patients showed that the use of intraoperative neurophysiological monitoring and the degree of operational and anesthetic risk according to the ASA scale have a significant effect.

About the authors

V. A. Byvaltsev

Irkutsk State Medical University; Railway Clinical Hospital on the station Irkutsk-Passazhirskiy of Russian Railways Ltd.; Irkutsk Scientific Center of Surgery and Traumatology; Irkutsk State Academy of Postgraduate Education; Institute of Nuclear Physics n.a. G.I. Budker of the SB RAS

Email: byval75vadim@yandex.ru
ORCID iD: 0000-0003-4349-7101

Доктор медицинских наук, главный нейрохирург Дирекции здравоохранения ОАО «РЖД»; руководитель Центра нейрохирургии ДКБ на ст. Иркутск-Пассажирский ОАО «РЖД-Медицина»; заведующий курсом нейрохирургии ИГМУ; заведующий научно-клиническим отделом нейрохирургии Иркутского научного центра хирургии и травматологии; профессор кафедры травматологии, ортопедии и нейрохирургии ИГМАПО; ведущий научный сотрудник ИЯФ им. Г.И. Будкера.

664082, Иркутск, ул. Боткина, д. 10, тел.: +7 (3952) 63-85-28.

SPIN-код: 5996-6477

Russian Federation

I. A. Stepanov

Irkutsk State Medical University

Author for correspondence.
Email: edmoilers@mail.ru
ORCID iD: 0000-0001-9039-9147

Аспирант курса нейрохирургии.

664003, Иркутск, ул. Красного Восстания, д. 14, тел.: +7 (3952) 63-88-30.

SPIN-код: 5485-5316

Russian Federation

E. G. Belykh

Irkutsk State Medical University

Email: e.belykh@yandex.ru
ORCID iD: 0000-0003-2060-5739

Ассистент курса нейрохирургии.

664082, Иркутск, ул. Боткина, д. 10, тел.: +7 (3952) 63-85-28.

SPIN-код: 4191-8687

Russian Federation

M. A. Aliyev

Irkutsk State Medical University

Email: a.marat.a0903@mail.ru

Докторант курса нейрохирургии.

050006, Алма-Ата, мкр. Калкаман, д. 20, тел.: +7 (7272) 28-07-77.

SPIN-код: 1138-9307

Kazakhstan

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