Juárez-Rebollar D, Vásquez-Gijón R, Ortiz-Mejía CG, De LLA, Jaime-Aguirre A

Language: Spanish
References: 16
Page: 13-18
PDF size: 206.94 Kb.

ABSTRACT

Only 15% of all tumors of Central Nervous System are intraraquideal. Ottenhausen reports 60% occurring extramedullary, 30% intradural extramedullary, and only 10% intramedullary. Quality of life as a measure of postoperative outcomes in patients with spinal tumors is a valuable tool. In the present study we aimed to evaluate the quality of life in patients with resection of spinal tumors through a tubular approach with self-completion questionnaires and medical assessment scales. A prospective, observational study was carried out at the National Medical Center 20 de Noviembre, in the period from March 2023 to August 2023. Patients of all ages with intradural extramedullary tumor lesions, who had a complete study protocol, were included, single lesions, with a rigid tubular approach to which different scales were applied to assess functionality, and degree of affectation to daily activities. After the surgical procedure, the functionality scales and a satisfaction survey were evaluated again. Six patients met criteria for a minimally invasive procedure. Female sex n = 4, meningioma n = 4 and schwannoma n = 2, the characteristics of the tumors were reported, the hospital stay time was 2.6 days on average, bleeding of 71.6 ml, no changes in intraoperative monitoring, in any case some complication occurred, total resection was achieved in 80% of the cases. To assess functional status, the pre- and postoperative scales were compared, and satisfaction surveys were also conducted. All patients reported clinical improvement, satisfaction with the procedure, and return to their activities in 5 of the 6 cases. We can conclude that quality of life is good, after resection of tumors through a tubular approach, by requiring a shorter hospital stay, and a shorter functional recovery time.

REFERENCES

1. He Z, Sui-To W, Kwong-Yui Y. Newly-diagnosed, histologically-confirmed central nervous system tumours in a Regional Hospital in Hong Kong: an epidemiological study of a 21-year period. J Korean Neurosurg Soc. 2020; 63: 119-135.

2. Ottenhausen M, Ntoulias G, Bodhinayake I, Ruppert FH, Schreiber S, Forschler A, et al. Intradural spinal tumors in adults-update on management and outcome. Neurosurg Rev. 2019; 42: 371-388.

3. Boukebir MA, Berlin CD, Navarro-Ramirez R, et al. Ten-step minimally invasive spine lumbar decompression and dural repair through tubular retractors. Oper Neurosurg. 2017; 13: 232-245.

4. Nzokou A, Weil A, Shedid D. Minimally invasive removal of thoracic and lumbar spinal tumors using a nonexpandable tubular retractor. J Neurosurg Spine. 2013; 19: 708-715.

5. Wang X, Wang J, Wang L, et al. Surgical resection of dorsal spinal meningiomas with the inner dura layer-an improved preservation technique of spinal dura in 40 cases. World Neurosurg. 2022; 160: e250-e255.

6. Balasubramanian SC, Nair AR, Saphiya NN, Madan A, Mathews SS. Minimally invasive resection of spinal tumors with tubular retractor: case series, surgical technique, and outcome. World Neurosurg. 2021; 149: e612-e621.

7. He Z, Li CY, Mak CH, Tse TS, Cheung FC. Minimally invasive tubular retractor surgery for intradural extramedullary spinal tumor reduces postoperative degeneration of paraspinal muscle. Asian J Neurosurg. 2022; 17: 74-84.

8. Bellut D, Burkhardt JK, Mannion AF, Porchet F. Assessment of outcome in patients undergoing surgery for intradural spinal tumor using the multidimensional patient-rated Core Outcome Measures Index and the modified McCormick scale. Neurosurg Focus. 2015; 39: E2.

9. Guirado VM, Taricco MA, Nobre MR, et al. Quality of life in adult intradural primary spinal tumors: 36-item short form health survey correlation with McCormick and Aminoff-Logue scales. J Neurosurg Spine. 2013; 19: 721-735.

10. Janssen SJ, Teunis T, van Dijk E, et al. Validation of the spine oncology study group-outcomes questionnaire to assess quality of life in patients with metastatic spine disease. Spine J. 2017; 17: 768-776.

11. Paulino Pereira NR, Janssen SJ, Stoop N, et al. Physical function and quality of life after resection of mobile spine chondrosarcoma. Global Spine J. 2019; 9: 743-753.

12. Ogura Y, Kobayashi Y, Shinozaki Y, et al. Factors influencing patient satisfaction after decompression surgery without fusion for lumbar spinal stenosis. Global Spine J. 2020; 10: 627-632.

13. Krauss P, Reinartz F, Sonnleitner C, et al. The relation of patient expectations, satisfaction, and outcome in surgery of the cervical spine: a prospective study. Spine. 2022; 47: 849-858.

14. Feghali J, Pennington Z, Ehresman J, et al. Predicting postoperative quality-of-life outcomes in patients with metastatic spine disease: who benefits? J Neurosurg Spine. 2020; 34: 383-389.

15. Tarantino R, Donnarumma P, Nigro L, et al. Surgery of intradural extramedullary tumors: retrospective analysis of 107 cases. Neurosurgery. 2014; 75: 509-514.

16. Versteeg AL, Sahgal A, Kawahara N, et al. Patient satisfaction with treatment outcomes after surgery and/or radiotherapy for spinal metastases. Cancer. 2019; 125: 4269-4277.