title: Sporadic spinal hemangioblastomas can be effectively treated by microsurgery alone.
abstract: OBJECTIVE
  Clinical characteristics and management of hemangioblastomas of the spinal cord associated with von Hippel-Lindau syndrome have been extensively covered in the literature. This report aims to analyze the characteristics and surgical treatment results of sporadic spinal hemangioblastomas (SSHB).
  
  
  METHODS
  This is a retrospective analysis of 14 patients with SSHB (8 men and 6 women) operated on during a span of 23 years. The median age was 41.5 years (24-70 years). von Hippel Lindau syndrome was excluded by imaging in all patients. The median follow-up was 4 years (1-23 years). We also conducted a meta-analysis of all 271 SSHB cases reported in the English-speaking language literature from 1967 to 2011.
  
  
  RESULTS
  Nine (64.3%) lesions were cervical, 3 (28.5%) were thoracic, and 1 (7.1%) was lumbar. Eight (57.1%) tumors were dorsal intramedullary, 4 (28.6%) were exophytic, 1 (7.1%) was intradural extramedullary, and 1 (7.1%) was completely extradural. Diffuse segmental cord enlargement was present in 7 patients (50%) and a cyst/syrinx was present in 7 (50%). These 14 patients underwent 15 operations, and gross total resection was achieved in all operations. There was no mortality. Symptoms improved after 8 (53.3%) of 15 operations, remained the same after 5 (33.3%), and worsened after 2 (13.3%). The mean Karnofsky performance score improved from 79.3 (± 17.5) to 87.3 (± 12.2) after 6 months of follow-up. There was one recurrence 15 years after magnetic resonance imaging confirmed total resection.
  
  
  CONCLUSIONS
  The SSHBs occur most often in the upper spinal cord. Excellent surgical results and long-term outcome can be achieved using microsurgery alone with only rare recurrences.
authors.affiliation: Department of Neurosurgery, Acibadem University, School of Medicine, Istanbul, Turkey.
authors.forename: H İbrahim
authors.initials: Hİ
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, Acibadem University, School of Medicine, Istanbul, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Özduman
authors.affiliation: Department of Neurosurgery, Acibadem University, School of Medicine, Istanbul, Turkey.
authors.forename: M İmre
authors.initials: Mİ
authors.lastname: Usseli
authors.affiliation: Department of Neurosurgery, Acibadem University, School of Medicine, Istanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Özgen
authors.affiliation: Department of Neurosurgery, Acibadem University, School of Medicine, Istanbul, Turkey. Electronic address: koray.ozduman@superonline.com.
authors.forename: M Necmettin
authors.initials: MN
authors.lastname: Pamir
mesh_terms: D000328:Adult; D000368:Aged; D066193:Cervical Cord / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018325:Hemangioblastoma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: Hemangioblastoma; Microsurgery; Spinal surgery; von Hippel Lindau