Long-Term Follow-Up of Patients with Metastatic Epidural Spinal Cord Compression from Solid Tumors Submitted for Surgery Followed by Radiation Therapy

Spinal meningiomas are the most common adult primary spinal tumor, constituting 24–45% of spinal intradural tumors and 2% of all meningiomas. The aim of this study was to assess postoperative complications, long-term outcomes, predictors of functional improvement and differences between elderly (≥70 years) and non-elderly (18–69 years) patients surgically treated for spinal meningiomas. Variables were retrospectively collected from patient charts and magnetic resonance images. Baseline comparisons, paired testing and regression analyses were used. In conclusion, 129 patients were included, with a median follow-up time of 8.2 years. Motor deficit was the most common presenting symptom (66%). The median time between diagnosis and surgery was 1.3 months. A postoperative complication occurred in 10 (7.8%) and tumor growth or recurrence in 6 (4.7%) patients. Surgery was associated with significant improvement of motor and sensory deficit, gait disturbance, bladder dysfunction and pain. Time to surgery, tumor area and the degree of spinal cord compression significantly predicted postoperative improvement in a modified McCormick scale (mMCs) in the univariable regression analysis, and spinal cord compression showed independent risk association in multivariable analysis. There was no difference in improvement, complications or tumor control between elderly and non-elderly patients. We concluded that surgery of spinal meningiomas was associated with significant long-term neurological improvement, which could be predicted by time to surgery, tumor size and spinal cord compression.

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Primary Intradural Extramedullary Spinal Melanoma in the Lower Thoracic Spine

Case Reports in Oncological Medicine ◽

10.1155/2016/3815280 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Kathrin Hering ◽

Anke Bresch ◽

Donald Lobsien ◽

Wolf Mueller ◽

Rolf-Dieter Kortmann ◽

...

Keyword(s):

Spinal Cord ◽

Thoracic Spine ◽

Primary Melanoma ◽

Cord Compression ◽

Long Term Follow Up ◽

Intradural Extramedullary ◽

Lower Thoracic Spine ◽

Spinal Cord Decompression

Background Context.Up to date, only four cases of primary intradural extramedullary spinal cord melanoma (PIEM) have been reported. No previous reports have described a case of PIEM located in the lower thoracic spine with long-term follow-up.Purpose. Demonstrating an unusual, extremely rare case of melanoma manifestation.Study Design. Case report.Methods. We report a case of a 57-year-old female suffering from increasing lower extremity pain, left-sided paresis, and paraesthesia due to spinal cord compression caused by PIEM in the lower thoracic spine.Results. Extensive investigation excluded other possible primary melanoma sites and metastases. For spinal cord decompression, the tumor at level T12 was resected, yet incompletely. Adjuvant radiotherapy was administered two weeks after surgery. The patient was recurrence-free at 104 weeks after radiotherapy but presents with unchanged neurological symptoms.Conclusion. Primary intradural extramedullary melanoma (PIEM) is extremely rare and its clinical course is unpredictable.

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Surgical management of aggressive vertebral hemangiomas causing spinal cord compression: long-term clinical follow-up of five cases

Journal of Orthopaedic Science ◽

10.1007/s00776-010-1483-z ◽

2010 ◽

Vol 15 (3) ◽

pp. 350-356 ◽

Cited By ~ 37

Author(s):

Satoshi Kato ◽

Norio Kawahara ◽

Hideki Murakami ◽

Satoru Demura ◽

Katsuhito Yoshioka ◽

...

Keyword(s):

Spinal Cord ◽

Surgical Management ◽

Spinal Cord Compression ◽

Cord Compression ◽

Vertebral Hemangiomas

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The natural history and management of symptomatic and asymptomatic vertebral hemangiomas

Journal of Neurosurgery ◽

10.3171/jns.1993.78.1.0036 ◽

1993 ◽

Vol 78 (1) ◽

pp. 36-45 ◽

Cited By ~ 214

Author(s):

Mark W. Fox ◽

Burton M. Onofrio

Keyword(s):

Spinal Cord ◽

Radiation Therapy ◽

Spinal Cord Compression ◽

Neurological Deficit ◽

Cord Compression ◽

Tumor Removal ◽

Content Type ◽

Progressive Neurological Deficit ◽

Vertebral Hemangiomas

✓ Fifty-nine cases of vertebral hemangioma were seen at the Mayo Clinic between 1980 and 1990. Vertebral hemangiomas were discovered incidentally in 35 patients, while pain was the presenting complaint in 13 patients. Five patients presented directly with progressive neurological deficit requiring surgery, and six patients had surgery elsewhere for spinal cord compression and were referred for follow-up evaluation. To better define the natural history of these lesions, a historical review of these patients was conducted; progression of an asymptomatic or painful lesion to neurological symptoms was found in only two cases (mean follow-up period 7.4 years, range 1 to 35 years). New-onset back pain followed by subacute progression (mean time to progression 4.4 months, range 0.25 to 12 months) of a thoracic myelopathy was the most common presentation for patients with neurological deficit. Initially, all 11 patients with spinal cord compression underwent decompressive surgery with full neurological recovery. Recurrent neurological symptoms were observed in three of six patients following subtotal tumor resection and postoperative administration of 1000 cGy or less radiation therapy (mean follow-up period 8.7 years, range 1 to 17 years). No recurrences were noted in four patients who had subtotal excision plus radiotherapy between 2600 and 4500 cGy. One other patient had gross total tumor removal without radiotherapy and has not had a recurrence. Based on these patients and a review of the literature, the authors recommend annual neurological and radiological examinations for patients with hemangiomas associated with pain, especially young females with thoracic lesions in whom spinal cord compression is most likely to develop. Radiation therapy or embolization is an effective therapeutic alternative for patients with severe medically refractory pain. Regular follow-up monitoring for patients with asymptomatic lesions is unnecessary unless pain develops at the appropriate spinal level. It is concluded that management of patients with a progressive neurological deficit should include preoperative angiography and embolization, decompressive surgery with the approach determined by the degree of vertebral involvement and site of spinal cord compression, and postoperative radiation therapy in patients following subtotal tumor removal. Operative management and complications are discussed.

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Long-Term Follow-Up After Spinal Cord Injury in Canada

PsycEXTRA Dataset ◽

10.1037/e513252007-001 ◽

2006 ◽

Author(s):

Mark I. Tonack ◽

Sander L. Hitzig ◽

B. Catharine Craven ◽

Kent A. Campbell ◽

Kathryn A. Boschen ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cord Injury ◽

Long Term Follow Up

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OPEN HAEMORRHOIDS SURGERY IN SPINAL CORD INJURY PATIENTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i11.1532 ◽

2020 ◽

Vol 4 (11) ◽

Author(s):

Khaled Hassan

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Anal Fissure ◽

Open Surgery ◽

Anal Fissures ◽

Cord Injury ◽

Long Term Follow Up ◽

Grade Iii

This Pilot retrospective research conducted on the results of open surgery in patients with Grade III and IV haemorrhoids With SCI. No major complications had arisen at 6 weeks post-operative and all wounds had healed, but 1 patient Anal fissure recurrence. 75% of patients reported a substantial increase in anorectal anorexia during long-term follow-up. With symptoms. Five patients reported recurrences: three haemorrhoids (18 percent) and two anal fissures (25 percent). Keywords: Haemorrhoids, Pilot retrospective research, Anorectal Anorexia.

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