[Predictive factors of spinal deformity following surgery for intramedullary tumors]

Neurochirurgie. 2017 Nov;63(5):419-425. doi: 10.1016/j.neuchi.2015.12.005. Epub 2016 Jun 30.
[Article in French]

Abstract

Introduction: Spinal deformity following surgery for intramedullary tumors is a serious potential complication. The aim of the study was to identify potential predictive risk factors of spinal deformity after intramedullary tumor surgery.

Material and methods: Retrospective study including patients harboring intramedullary tumors who underwent surgery in a single center (Hôpital Bicêtre, AP-HP, Paris) between 1985 and 2011. The main outcome was the difference at last follow-up between post- and preoperative measure of Cobb angles formed by the superior and inferior limits of the laminectomy (Δ_Cobb).

Results: Sixty-three patients included. Mean sagittal deformity was 15.9° (0°-77°) for a mean follow-up of 85 months (4-240). Univariate analysis of potential predictive factors showed an increased deformity for patients undergoing a 4-or-more levels laminectomy, (19.3° versus 12.1°; P=0.04), for patients aged less or equal to 30 years of age and when it included a junction (20.8° versus 12.4°; P=0.02). A neurological deficit, either pre- or postoperatively, was not associated with a greater deformity. Multivariate analysis showed that only age (P=0.01) and the number of spinal levels involved (P=0.014) were significant and independent predictors of postoperative deformity.

Conclusion: This study indicates predictive factors of spinal deformity in any patient undergoing surgery for intramedullary tumors, allowing improvement in the planning of surgery and patients' follow-up.

Keywords: Déformation sagittale; Intramedullary tumor; Laminectomie; Laminectomy; Spinal deformity; Tumeur intramédullaire.

MeSH terms

  • Humans
  • Laminectomy / adverse effects*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / surgery*
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / etiology