Journal Article

Preoperative angiographic considerations and neurological outcome after surgical treatment of intradural spinal hemangioblastoma: a multicenter retrospective case series

Butenschoen, Vicki M., Czabanka, Marcus, Vajkoczy, Peter, Eicker, Sven O., Schwendner, Maximilian, Maurer, Stefanie, Onken, Julia, Hubertus, Vanessa, Boeckh-Behrens, Tobias, Koegl, Nikolaus, Mohme, Theresa, Wostrack, Maria, Thomé, Claudius, Meyer, Bernhard

2023

Overview

Purpose Intradural spinal hemangioblastomas are rare highly hypervascularized benign neoplasms. Surgical resection remains the treatment of choice, with a significant risk of postoperative neurological deterioration. Due to the tumor infrequency, scientific evidence is scarce and limited to case reports and small case series. Methods We performed a retrospective multicenter study including five high-volume neurosurgical centers analyzing patients surgically treated for spinal hemangioblastomas between 2006 and 2021. We assessed clinical status, surgical data, preoperative angiograms, and embolization when available. Follow-up records were analyzed, and logistic regression performed to assess possible risk factors for neurological deterioration. Results We included 60 patients in Germany and Austria. Preoperative angiography was performed in 30% of the cases; 10% of the patients underwent preoperative embolization. Posterior tumor location and presence of a syrinx favored gross total tumor resection (93.8% vs. 83.3% and 97.1% vs. 84%). Preoperative embolization was not associated with postoperative worsening. The clinical outcome revealed a transient postoperative neurological deterioration in 38.3%, depending on symptom duration and preoperative modified McCormick grading, but patients recovered in most cases until follow-up. Conclusion Spinal hemangioblastoma patients significantly benefit from early surgical treatment with only transient postoperative deterioration and complete recovery until follow-up. The performance of preoperative angiograms remains subject to center disparities.

• Publisher: Springer US,Springer Nature B.V
• Subject: Angiography / Case reports / Embolization / Hemangioblastoma - diagnostic imaging / Hemangioblastoma - surgery / Humans / Medicine / Medicine & Public Health / Neurology / Neurosurgery / Neurosurgical Procedures / Oncology / Patients / Retrospective Studies / Risk factors / Spinal Cord Neoplasms - diagnostic imaging / Spinal Cord Neoplasms - surgery / Treatment Outcome / Tumors