Retrospective cohort analysis of 101 patients who underwent surgery due to spinal tumors: A single-center experience

Abstract

Aim: To evaluate the clinical and surgical outcomes of the spinal tumor cases operated in our clinic. Methods: A total of 121 spinal lesions operated between January 2015 and January 2020 were retrospectively analyzed. Our study included 101 pathologically diagnosed patients. Results: Of the 101 patients, 47 were males and 54 were females. The youngest patient was 4 months old, the oldest was 82 years old (Mean 46.56 ± 19.05). A total of 52 patients presented with neurological deficits: 6 were Frankel A, 9 were Frankel B, 15 were Frankel C, and 22 were Frankel D. The thoracic region was the most frequently affected area (46.5%). It was observed that intradural extramedullary (51.5%), followed by extradural (36.6%) and then intramedullary (11.9%) were the most common. According to the pathological diagnosis, Schwannoma (n: 27), meningioma (n: 19), ependymoma (n: 11), metastasis (n: 19), lymphoma (n: 6), and other tumors (n: 19) were observed. According to the Frankel Scale, there was a decrease in the grade of 2 cases, an increase in the grade of 26 cases and no change in the grade of 73 cases. During follow-up with the patients MRI, it was observed that 32.7% cases had residual tumors, recurrence developed in 5.9% of cases, and progression occured in 5.9% of cases. Conclusion: Less neurological deficits were observed in our patients despite the aggressive management with the technology used. In addition, improvement in their neurological deficits were observed in the long term due to improved physical therapy.Therefore, developing technology, surgical experience, and aggressive surgical inference with postoperative physiotherapy should be considered.

Keywords

• Spinal tumor
• Frankel Scale
• histopathological diagnosis
• magnetic resonance imaging

Spinal tümörler nedeniyle ameliyat edilen 101 hastanın retrospektif kohort analizi: Tek merkez deneyimi

Öz

Amaç: Spinal tümörlerin tedavi stratejileri ve sonuçlarına genel bir bakış sağlamak amacıyla kliniğimizde opere edilen spinal tümör olgularının klinik ve cerrahi sonuçlarını literatür eşliğinde değerlendirmektir. Yöntemler: Ocak 2015 - Ocak 2020 tarihleri arasında kurumumuzda mikrocerrahi rezeksiyon uygulanan 101 spinal tümör hastası retrospektif olarak incelendi. Hastaların klinikleri, demografik bilgileri, görüntüleme yöntemleri, cerrahi yaklaşımlar, nöropatolojik tanı, postoperatif takip ve komplikasyonlardan oluşan veriler ve postoperatif nörolojik durumlar hakkındaki veriler toplandı. Hastaların nörolojik durumlarını değerlendirmek için Frankel skalası kullanıldı. Bulgular: 47 erkek ve 54 kadın hasta ortalama 14.2 ay takip edildi. Yerleşim yerlerine göre intradural ekstramedüller (% 51.5), ekstradural (% 36.6) ve intramedüller tümörler (% 11.9) oranda görüldü. En sık yerleşim yeri torasik (n = 47), ardından lomber bölgeydi (n = 26). En sık görülen histopatolojik tanı schwannoma (n = 27), menenjiyom (n = 19), metastaz (n = 19) ve ependimoma (n = 11) idi. Frankel skalasına göre, iki olgunun derecesinde azalma, 26 olgunun derecesinde artış olmuştu ve 73 olgunun derecesinde ise değişiklik olmamıştı. Hastaların magnetik rezonans görüntüleme takiplerinde % 32.7 rezidüel tümör, % 5.9 rekürrens ve % 5.9 progresyon olduğu görüldü. Sonuç: Gelişen preoperatif tanı yöntemleri, peroperatif araç ve gereçlerdeki teknolojik gelişmeler ve cerrahi tekniklerin gelişmesine rağmen, preoperatif nörolojik durum spinal tümörler için postoperatif fonksiyonun hala en güçlü prediktörü olmaya devam etmektedir. Ayrıca postoperatif takip sırasında hastalara yapılan erken magnetik rezonans görüntüleme incelemelerinin de nüks ve progresyon oranlarını belirlemede de önemlidir.

Anahtar Kelimeler

• Spinal tümör
• Frankel skalası

Kaynakça

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