Factors Affecting Surgical Outcome of Intramedullary Spinal Cord Tumors: A Prospective One-year Follow-Up Study

Abstract

Background Data: Identification of the prognostic factors of the surgical outcomes of intramedullary spinal cord tumors (IMSCTs) is essential. Many studies have established that early surgical intervention was associated with better outcomes and enhanced survival rates. Purpose: This study investigated the prognostic factors of the one-year surgical outcomes of patients with IMSCTs. Study Design: A prospective clinical case study. Patients and Methods: Twenty patients with IMSCTs, who underwent surgery in our institution and were followed up at our clinic were recruited for this study. Patients were followed up for one year to assess postoperative functional outcomes using the modified McCormick Scale (MMS). The reported parameters included preoperative MMS, use of operative monitoring, use of ultrasonic aspirator, the extent of tumor resection, and postoperative adjuvant therapy. Results: Operatively, 85% of patients underwent laminectomy, 55% reported growth total resection (GTR), 55% intraoperative monitoring, 75% underwent ultrasonic aspiration, 55% had syrinx, and 20% had duraplasty. The preoperative MMS improved from 3.0 to 2.32 and 2.42 postoperatively at six months and one year of follow-up, respectively. Patients with postoperative MMS ≤3 were more likely to undergo GTR with better postoperative MMS than those with preoperative MMS >3 at six-month follow-up (81.8% vs. 25%, respectively; p = 0.013) and at one-year follow-up (84.4 vs. 0%, respectively; p = 0.001). Good preoperative MMS, use of ultrasonic aspirator, and operative monitoring were associated with better MMS. There were no significant associations between MMS at the sixth month and reported parameters including gender, symptoms duration, tumor location, bony work whether laminectomy or laminoplasty, number of segments involved, tumor histopathology, duraplasty, and postoperative adjuvant therapy. Conclusion: The findings of the current study showed that patients with GTR, good preoperative MMS, intraoperative monitoring, and ultrasonic aspirator usage might be associated with better functional outcomes. (2021ESJ229)