Surgical management of spinal cord haemangioblastoma

Acta Neurochir (Wien). 2008 Mar;150(3):215-20; discussion 220. doi: 10.1007/s00701-008-1396-6. Epub 2008 Feb 7.

Abstract

Background: The surgical management of spinal cord haemangioblastomas is distinct from that of other benign spinal cord tumours and optimal surgical strategy is still being determined because of the rarity of the condition. The aim of this study is to investigate factors that affect the outcome of surgical management.

Patients and methods: We retrospectively analysed 24 operations for symptomatic spinal cord haemangioblastomas in 20 patients. Clinical features and surgical results were investigated by medical record review, telephone interviews, angiographic images, and magnetic resonance images (MRI). The mean follow-up period was 5.6 years (range 6 months to 13.6 years).

Results: Patients with cystic components showed pre-operative motor weakness and sensory change more commonly than those without cystic components. Post-operative function scale had a positive correlation with pre-operative function (R(2) = 0.727; p < 0.001) and no correlation with the extent of the surgery. All subtotally removed tumours recurred, whereas totally removed tumours recurred in only 3 patients.

Conclusion: The cystic component of spinal cord haemangioblastomas is responsible for symptom generation and is helpful for dissecting tumours. Post-operative functional status is determined by pre-operative functional status. Total removal is feasible by using the correct surgical technique and is recommended to prevent recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Electrocoagulation / methods
  • Electrocoagulation / standards
  • Female
  • Hemangioblastoma / pathology
  • Hemangioblastoma / physiopathology
  • Hemangioblastoma / surgery*
  • Humans
  • Intraoperative Complications / prevention & control
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Neoplasm Recurrence, Local / prevention & control
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / standards
  • Neurosurgical Procedures / statistics & numerical data
  • Paresis / etiology
  • Paresis / physiopathology
  • Preoperative Care / methods
  • Recovery of Function / physiology
  • Retrospective Studies
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology
  • Spinal Cord / pathology
  • Spinal Cord / physiopathology
  • Spinal Cord / surgery*
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / physiopathology
  • Spinal Cord Neoplasms / surgery*
  • Treatment Outcome