Surgical management of spinal cord haemangioblastoma.
BACKGROUND
The surgical management of spinal cord haemangioblastomas is distinct from that of other benign spinal cord tumours and optimal surgical strategy is still being determined because of the rarity of the condition. The aim of this study is to investigate factors that affect the outcome of surgical management.


METHODS
We retrospectively analysed 24 operations for symptomatic spinal cord haemangioblastomas in 20 patients. Clinical features and surgical results were investigated by medical record review, telephone interviews, angiographic images, and magnetic resonance images (MRI). The mean follow-up period was 5.6 years (range 6 months to 13.6 years).


RESULTS
Patients with cystic components showed pre-operative motor weakness and sensory change more commonly than those without cystic components. Post-operative function scale had a positive correlation with pre-operative function (R(2) = 0.727; p < 0.001) and no correlation with the extent of the surgery. All subtotally removed tumours recurred, whereas totally removed tumours recurred in only 3 patients.


CONCLUSIONS
The cystic component of spinal cord haemangioblastomas is responsible for symptom generation and is helpful for dissecting tumours. Post-operative functional status is determined by pre-operative functional status. Total removal is feasible by using the correct surgical technique and is recommended to prevent recurrence.
Shin
D A
DA
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Kim
S H
SH
Kim
K N
KN
Shin
H C
HC
Yoon
D H
DH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D004564:Electrocoagulation / Q000379:methods / Q000592:standards; D005260:Female; D018325:Hemangioblastoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome