title: Factors Affecting Postoperative Neurological Deficits After Nerve Root Resection for the Treatment of Spinal Intradural Schwannomas.
abstract: METHODS
  A retrospective clinical data analysis.
  
  
  OBJECTIVE
  To investigate the factors related to postoperative neurological deficits after nerve root resection in the treatment of spinal intradural schwannoma.
  
  
  BACKGROUND
  Neurological deficits could be observed after resection of tumor-involved nerve roots in spinal intradural schwannoma. Thus, it is important to find the factors related to postoperative neurological deficits.
  
  
  METHODS
  Clinical and pathological data were selected from patients underwent total resection of the solitary spinal intradural schwannoma from T11 to S. Patients were divided into the postoperative neurological deficits positive group (PND group, n = 12) and negative group (non-PND group, n = 52). Clinical features including age, sex, duration of disorders, diabetes, preoperative visual analogue scale (VAS) and SF-36 score, preoperative symptoms, tumor size, tumor location, and immunostaining results were analyzed.
  
  
  RESULTS
  Age, sex, duration of disorders, diabetes, preoperative VAS and SF-36 score, tumor length, and tumor-occupied ratio were not significantly different between the two groups (P > 0.05). Lower extremity pain, sensory disturbance, and motor disturbance were found in 25.0%, 50.0%, and 75.0% of patients in the PND group and 76.9%, 17.3%, and 7.7% of patients in the non-PND group, respectively, and the results were significantly different (P < 0.05). The rate of postoperative neurological deficits was higher when the tumor was located in the thoracolumbar junction (T11-L2) than other segments (L2-S; P = 0.009). For immunostaining study, CD34-positive rate was significantly different between the two groups (P = 0.013).
  
  
  CONCLUSIONS
  The absence of preoperative lower extremity pain, presence of sensory and motor disturbances, and tumor location in the thoracolumbar junction (T11-L2) are the predictors of postoperative neurological deficits. Age, sex, duration of the disorders, diabetes, preoperative VAS score, preoperative SF-36 score, tumor length, and tumor-occupied ratio are not related to postoperative neurological deficits. On immunostaining of tumors, CD34-negative results are related to the development of postoperative neurological deficits.
  
  
  METHODS
  4.
authors.affiliation: Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Zou
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Guan
authors.forename: Jianyuan
authors.initials: J
authors.lastname: Jiang
authors.forename: Feizhou
authors.initials: F
authors.lastname: Lu
authors.forename: Wenjun
authors.initials: W
authors.lastname: Chen
authors.forename: Xinlei
authors.initials: X
authors.lastname: Xia
authors.forename: Lixun
authors.initials: L
authors.lastname: Wang
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000601:surgery*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D055815:Young Adult