title: Outcome of surgical decompression of spinal mass lesions in non-Hodgkin's lymphoma and plasmacytoma.
abstract: OBJECTIVE
  Surgical treatment for spinal mass lesions due to non-Hodgkin's lymphoma (NHL) or plasmacytoma is necessary only in rare instances. The purpose of this study was to investigate long-term outcome and quality of life of surgery combined with postoperative chemotherapy or radiochemotherapy.
  
  
  METHODS
  The data of patients, who underwent spinal surgery for mass lesions in a 10-year periods were reviewed, identifying 10 patients with a histopathological diagnosis of NHL or plasmacytoma. Functional outcome were assessed by the Karnofsky Performance Score (KPS), quality of life by the Short Form-36 (SF-36) Health Survey Questionnaire, and pain by the Visual Analog Scale (VAS).
  
  
  RESULTS
  Clinical presentations included pain (n=10), paresis (n=5), and sensory deficits (n=5). Surgical treatment included removal of the mass lesion (total, n=5; subtotal, n=5) for decompression, interbody fusion (n=3), and corporectomy followed by stabilization (n=1). Histopathological findings revealed NHL in five patients and plasmacytoma/multiple myeloma in five other patients. Postoperatively, all patients underwent chemotherapy or radiochemotherapy. Mean follow-up time was 38 months. At the last follow-up, 2 patients had succumbed to progression of disease. Pain intensity remained significantly reduced as compared to preoperatively (p=0.049). The KPS was 90-100% in five patients still alive, 70% in two, and 60% in one. SF-36 subscores were lower as compared to age-matched healthy controls.
  
  
  CONCLUSIONS
  This retrospective study shows that surgical decompression of spinal mass lesions is a valuable option in selected patients with NHL or plasmacytoma to improve neurological deficits and control pain. Long-term outcome after postoperative adjuvant therapy confirms prolonged stability of quality of life.
authors.affiliation: Department of Neurosurgery, Hannover Medical School, Hannover, Germany. Electronic address: hong.bujung@mh-hannover.de.
authors.forename: Bujung
authors.initials: B
authors.lastname: Hong
authors.forename: Elvis J
authors.initials: EJ
authors.lastname: Hermann
authors.forename: Christoph
authors.initials: C
authors.lastname: Reuter
authors.forename: Almuth
authors.initials: A
authors.lastname: Brandis
authors.forename: Joachim K
authors.initials: JK
authors.lastname: Krauss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement; D010954:Plasmacytoma / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Non-Hodgkin's lymphoma; Plasmacytoma; Spinal mass lesion; Surgical decompression