2024-03-29T11:10:38Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00024953
2023-01-16T04:45:57Z
499:500:501
Optimal Timing of Surgery for Intramedullary Cavernous Hemangioma of the Spinal Cord in Relation to Preoperative Motor Paresis, Disease Duration, and Tumor Volume and Location
Imagama, Shiro
74391
Ito, Zenya
74392
Ando, Kei
74393
Kobayashi, Kazuyoshi
74394
Hida, Tetsuro
74395
Ito, Kenyu
74396
Tsushima, Mikito
74397
Ishikawa, Yoshimoto
74398
Matsumoto, Akiyuki
74399
Morozumi, Masayoshi
74400
Tanaka, Satoshi
74401
Machino, Masaaki
74402
Ota, Kyotaro
74403
Nakashima, Hiroaki
74404
Wakao, Norimitsu
74405
Sakai, Yoshihito
74406
Matsuyama, Yukihiro
74407
Ishiguro, Naoki
74408
Study Design: Prospective study. Objective: Investigate factors associated with preoperative motor paresis, recovery, ambulatory status, and intraoperative neurophysiological monitoring (IONM) among patients with no preoperative paresis (N group), complete preoperative motor recovery (CR group), and no complete recovery (NCR group) in patients with intramedullary spinal cavernous hemangioma to determine the optimal timing of surgery. Methods: The study evaluated 41 surgical cases in our institute. Disease duration, tumor lesion, manual muscle testing (MMT), and gait at onset, just before surgery, and final follow-up (FU), tumor and lesion volume, IONM, extent of tumor resection, and tumor recurrence were evaluated among N, CR, and NCR groups. Results: Motor paresis at onset was found in 26 patients (63%), with 42% of those in CR group. Disease duration from onset negatively affected stable gait just before surgery and FU as well as lower preoperative MMT (P < .05). Thoracic tumors were associated with patients with unstable gait before surgery (P < .05). Tumor volume was larger in NCR group (P < .05). IONM significantly decreased in NCR and CR groups than in N group (P < .05). The NCR group had residual mild motor paresis at FU (P < .05). Stable gait at FU was similar in N group and CR group, though lower in NCR group (P < .05). Conclusions: Early surgery is generally recommended for thoracic tumors and large tumors during stable gait without motor paresis before long disease duration. Surgery may be postponed until patients recover from preoperative motor paresis to allow optimal surgical outcome. IONM should be carefully monitored in patients with a history of preoperative paresis even with preoperative complete motor recovery.
journal article
SAGE Publications
2017-06
application/pdf
Global Spine Journal
3
7
246
253
https://doi.org/10.1177/2192568217707938
http://hdl.handle.net/2237/27175
2192-5682
https://nagoya.repo.nii.ac.jp/record/24953/files/10_1177_2192568217707938.pdf
eng
https://doi.org/10.1177/2192568217707938
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/ licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).