Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register)
Background: Intramedullary tumors represent only 10% of the spectrum of spinal tumors. Their management is not an easy task and depends essentially on the surgical resection which can be very challenging. The main aim of our study was to analyze the complication rate in intramedullary tumors as well...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Craniovertebral Junction and Spine |
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| Online Access: | https://journals.lww.com/10.4103/jcvjs.jcvjs_130_24 |
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| author | Juan Manuel Vinas-Rios Vincent J. Heck Fatima Azucena Medina-Govea Mario Alberto Islas-Aguilar Nikolaus Kernich DWG-Registry Group |
| author_facet | Juan Manuel Vinas-Rios Vincent J. Heck Fatima Azucena Medina-Govea Mario Alberto Islas-Aguilar Nikolaus Kernich DWG-Registry Group |
| author_sort | Juan Manuel Vinas-Rios |
| collection | DOAJ |
| description | Background:
Intramedullary tumors represent only 10% of the spectrum of spinal tumors. Their management is not an easy task and depends essentially on the surgical resection which can be very challenging. The main aim of our study was to analyze the complication rate in intramedullary tumors as well as postoperative outcome after intramedullary tumor resection.
Methods:
This was a retrospective analysis of data from the “DWG-Register” of patients who have undergone operative treatment for primary intramedullary tumors in 170 departments from January 2017 to May 2021. Since 2017, pre-, intra-, and postoperative data until demission from the hospital have been continually collected in the “DWG-Register” (a total of 179,955 in a period of 4 years in 170 departments).
Results:
In total, 307 primary intramedullary tumors in the spine were identified; n = 248 (Group 1) had nonoperative complications and n = 59 had a complication related to the surgical procedure (Group 2); taking this in to account, die complication rate was 19.2%. The incidence of complications was: epidural hematoma n = 5 (8.4%), paresis n = 23 (38.9%), bowel/bladder dysfunction n = 15 (25.4%), wound infection n = 5 (8.4%), medullary injury n = 2 (3.4%), cerebrospinal fluid (CSF) leakage n = 15 (25.4%), and reintervention with hematoma, abscess, or surgical CSF leakage management in n = 22 (37.2%). The risk of permanent morbidity increased with a thoracic level, masculine gender, a long clinical history, presence of epidural hemorrhage, blood transfusion, and surgery on a recurrent tumor.
Conclusion:
Medullary tumors are a rare entity with a relative high complication rate (20%). Improvement of symptoms postoperative depends on several factors such as operated level, masculine gender, a long clinical history, presence of epidural hemorrhage, blood transfusion, and surgery on a recurrent tumor. In rare pathologies such as intramedullary tumors, the data from the DWG Register can be used to describe spinal surgery care in “real life.” |
| format | Article |
| id | doaj-art-bfa02fa144ff4c49a014f79bdfdd53e3 |
| institution | Kabale University |
| issn | 0974-8237 0976-9285 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj-art-bfa02fa144ff4c49a014f79bdfdd53e32025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115442743210.4103/jcvjs.jcvjs_130_24Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register)Juan Manuel Vinas-RiosVincent J. HeckFatima Azucena Medina-GoveaMario Alberto Islas-AguilarNikolaus KernichDWG-Registry GroupBackground: Intramedullary tumors represent only 10% of the spectrum of spinal tumors. Their management is not an easy task and depends essentially on the surgical resection which can be very challenging. The main aim of our study was to analyze the complication rate in intramedullary tumors as well as postoperative outcome after intramedullary tumor resection. Methods: This was a retrospective analysis of data from the “DWG-Register” of patients who have undergone operative treatment for primary intramedullary tumors in 170 departments from January 2017 to May 2021. Since 2017, pre-, intra-, and postoperative data until demission from the hospital have been continually collected in the “DWG-Register” (a total of 179,955 in a period of 4 years in 170 departments). Results: In total, 307 primary intramedullary tumors in the spine were identified; n = 248 (Group 1) had nonoperative complications and n = 59 had a complication related to the surgical procedure (Group 2); taking this in to account, die complication rate was 19.2%. The incidence of complications was: epidural hematoma n = 5 (8.4%), paresis n = 23 (38.9%), bowel/bladder dysfunction n = 15 (25.4%), wound infection n = 5 (8.4%), medullary injury n = 2 (3.4%), cerebrospinal fluid (CSF) leakage n = 15 (25.4%), and reintervention with hematoma, abscess, or surgical CSF leakage management in n = 22 (37.2%). The risk of permanent morbidity increased with a thoracic level, masculine gender, a long clinical history, presence of epidural hemorrhage, blood transfusion, and surgery on a recurrent tumor. Conclusion: Medullary tumors are a rare entity with a relative high complication rate (20%). Improvement of symptoms postoperative depends on several factors such as operated level, masculine gender, a long clinical history, presence of epidural hemorrhage, blood transfusion, and surgery on a recurrent tumor. In rare pathologies such as intramedullary tumors, the data from the DWG Register can be used to describe spinal surgery care in “real life.”https://journals.lww.com/10.4103/jcvjs.jcvjs_130_24intramedullary tumorsspine registryspine surgery |
| spellingShingle | Juan Manuel Vinas-Rios Vincent J. Heck Fatima Azucena Medina-Govea Mario Alberto Islas-Aguilar Nikolaus Kernich DWG-Registry Group Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register) Journal of Craniovertebral Junction and Spine intramedullary tumors spine registry spine surgery |
| title | Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register) |
| title_full | Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register) |
| title_fullStr | Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register) |
| title_full_unstemmed | Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register) |
| title_short | Perioperative complications in primary intramedullary tumors of the spine in adults. A multicenter surveillance study of 307 patients from the German Spine Registry (DWG-Register) |
| title_sort | perioperative complications in primary intramedullary tumors of the spine in adults a multicenter surveillance study of 307 patients from the german spine registry dwg register |
| topic | intramedullary tumors spine registry spine surgery |
| url | https://journals.lww.com/10.4103/jcvjs.jcvjs_130_24 |
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