Surgical outcomes of spinal cavernous malformations: A retrospective study of 98 patients

Frontiers in Surgery, 2023 · DOI: 10.3389/fsurg.2022.1075276 · Published: January 12, 2023

Spinal Cord Injury Cardiovascular Science Surgery

Simple Explanation

Spinal cord cavernous malformations (SCCM) are rare vascular lesions in the spinal cord. This study analyzes the surgical outcomes of 98 patients with SCCM to determine better treatment strategies. The study found that early surgical resection (within 3 months of symptom onset) generally leads to a better prognosis, especially for severe symptomatic SCCMs.

Study Duration

2009 to 2018

Participants

98 patients with SCCM

Evidence Level

Retrospective study

Key Findings

1
Patients with dorsal or superficial lesions showed better improvement than those with ventral or lateral deep lesions.
2
Earlier surgical resection (within 3 months of symptom duration) may lead to a better prognosis.
3
There was no significant difference in prognosis between hemilaminectomy and laminectomy.

Research Summary

This retrospective study analyzed the surgical outcomes of 98 patients with spinal cord cavernous malformations (SCCM) treated between 2009 and 2018. The study found that patients with dorsal or superficial lesions and those undergoing earlier surgery (within 3 months of symptom onset) had better outcomes. The authors conclude that surgical strategies should be preferred for severe symptomatic SCCMs if total resection can be achieved and that the surgical strategy for ventral or lateral deep SCCMs should be considered more carefully.

Practical Implications

Surgical Preference for Severe Cases

For severe symptomatic SCCMs, surgery should be considered the first choice to avoid complications.

Importance of Early Intervention

Early microsurgical resection might improve the prognosis of patients with neurological deficits, preferably within 3 months of symptom onset.

Careful Consideration for Deep Lesions

Surgical treatment for CM located in the ventral or deep lateral spinal cord should be more carefully considered.

Study Limitations

1
Single-center retrospective nature and small sample size lead to selection bias.
2
Lack of data for conservatively treated patients.
3
Extreme scarcity of SCCM, limiting prospective studies and/or randomized trials.

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