title: Improved patient quality of life following intradural extramedullary spinal tumor resection.
abstract: OBJECTIVE Resection significantly improves the clinical symptoms and functional outcomes of patients with intradural extramedullary tumors. However, patient quality of life following resection has not been adequately investigated. The aim in this retrospective analysis of prospectively collected quality of life outcomes is to analyze the efficacy of resection of intradural extramedullary spinal tumors in terms of quality of life markers. METHODS A retrospective review of a single institutional neurosurgical administrative database was conducted to analyze clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) for pain, and the EQ-5D-3 L descriptive system were used to analyze quality of life preoperatively, less than 1 month postoperatively, 1-3 months postoperatively, 3-12 months postoperatively, and more than 12 months postoperatively. RESULTS The ODI scores increased perioperatively at the < 1-month follow-up from 36 preoperatively to 47. Relative to preoperative values, the ODI score decreased significantly at 1-3, 3-12, and > 12 months to 23, 17, and 20, respectively. VAS scores significantly decreased from 6.1 to 3.5, 2.4, 2.0, and 2.9 at the < 1-month, 1- to 3-, 3- to 12-, and > 12-month follow-ups, respectively. EQ-5D mobility significantly worsened at the < 1-month follow-up but improved at the 3- to 12-and > 12-month follow-ups. EQ-5D self-care significantly worsened at the < 1-month follow-up but significantly improved by the 3- to 12-month follow-up. EQ-5D usual activities improved at the 1- to 3-, 3- to 12-, and > 12-month follow-ups. EQ-5D pain and discomfort significantly improved at all follow-up points. EQ-5D anxiety and depression significantly improved at 1- to 3-month and 3- to 12-month follow-ups. CONCLUSIONS Resection of intradural extramedullary spine tumors appears to significantly improve patient quality of life by decreasing patient disability and pain and by improving each of the EQ-5D domains.
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Viereck
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania.
authors.forename: George M
authors.initials: GM
authors.lastname: Ghobrial
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania.
authors.forename: Sara
authors.initials: S
authors.lastname: Beygi
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania.
authors.forename: James S
authors.initials: JS
authors.lastname: Harrop
mesh_terms: D000203:Activities of Daily Living; D000072716:Cancer Pain / Q000523:psychology / Q000601:surgery; D016208:Databases, Factual; D004185:Disability Evaluation; D004806:Ependymoma / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D009455:Neurofibroma / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: ODI = Oswestry Disability Index; VAS = visual analog scale; functional outcome; intradural extramedullary; intradural tumor; nerve sheath tumor; neurofibroma; neurofibromatosis; oncology; quality of life; schwannoma; spinal tumor