Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study
Background/Objectives: While most studies on the postoperative condition of patients with spinal cord tumors describe long-term outcomes, data are needed on immediate surgical outcomes demanding rehabilitation to make informed assessments for postoperative planning. The aim of this study was to iden...
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2025-01-01
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| author | Stanisław Krajewski Jacek Furtak Monika Zawadka-Kunikowska Michał Kachelski Jakub Soboń Marek Harat |
| author_facet | Stanisław Krajewski Jacek Furtak Monika Zawadka-Kunikowska Michał Kachelski Jakub Soboń Marek Harat |
| author_sort | Stanisław Krajewski |
| collection | DOAJ |
| description | Background/Objectives: While most studies on the postoperative condition of patients with spinal cord tumors describe long-term outcomes, data are needed on immediate surgical outcomes demanding rehabilitation to make informed assessments for postoperative planning. The aim of this study was to identify factors predicting function and rehabilitative needs after intradural spinal tumor surgery. Methods: Eighty-five prospectively recruited patients underwent surgery for intradural intramedullary (ID-IM; <i>n</i> = 23) and extramedullary (ID-EM; <i>n</i> = 62) tumors. Neurological and functional status were assessed before surgery, after surgery, and at discharge using the modified McCormick scale (MMS), Karnofsky performance status (KPS) scale, Barthel index (BI), and the gait index (GI). Results: There were no significant predictors of early postoperative rehabilitation in the ID-IM group. In the ID-EM group, age, thoracic level, subtotal resection (STR), repeat surgery, and functional scale scores predicted the need for rehabilitation. In multivariable analysis, MMS (odds ratio (OR) 8.7; 95% confidence interval (CI): 2.37–32.44) and STR (OR 13.00; 95%CI: 1.56–107.87) remained independent predictors of rehabilitation need (area under curve, 92%). Despite their younger age, most patients with ID-IM tumors, especially ependymomas, required rehabilitation but improved quickly (KPS, BI, <i>p</i> < 0.001). Among ID-EM tumors, meningiomas were characterized by poorer preoperative function and low gross total resection (GTR) rates, but did not deteriorate neurologically after surgery. Patients with schwannoma and ID-EM ependymomas achieved the highest GTR rate and had the best function both before and after surgery. Conclusions: These results may be useful for estimating early rehabilitation needs after intradural tumor surgery and counseling patients before surgery about the expected postoperative course. |
| format | Article |
| id | doaj-art-f551171560864d2e9ce0559ed2315f14 |
| institution | Kabale University |
| issn | 2076-3425 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj-art-f551171560864d2e9ce0559ed2315f142025-01-24T13:25:49ZengMDPI AGBrain Sciences2076-34252025-01-011515110.3390/brainsci15010051Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective StudyStanisław Krajewski0Jacek Furtak1Monika Zawadka-Kunikowska2Michał Kachelski3Jakub Soboń4Marek Harat5Centre of Medical Sciences, Jan and Jędrzej Śniadeccy University of Science and Technology, 85-796 Bydgoszcz, PolandCentre of Medical Sciences, Jan and Jędrzej Śniadeccy University of Science and Technology, 85-796 Bydgoszcz, PolandDepartment of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, 85-092 Bydgoszcz, PolandDepartment of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, PolandDepartment of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, PolandCentre of Medical Sciences, Jan and Jędrzej Śniadeccy University of Science and Technology, 85-796 Bydgoszcz, PolandBackground/Objectives: While most studies on the postoperative condition of patients with spinal cord tumors describe long-term outcomes, data are needed on immediate surgical outcomes demanding rehabilitation to make informed assessments for postoperative planning. The aim of this study was to identify factors predicting function and rehabilitative needs after intradural spinal tumor surgery. Methods: Eighty-five prospectively recruited patients underwent surgery for intradural intramedullary (ID-IM; <i>n</i> = 23) and extramedullary (ID-EM; <i>n</i> = 62) tumors. Neurological and functional status were assessed before surgery, after surgery, and at discharge using the modified McCormick scale (MMS), Karnofsky performance status (KPS) scale, Barthel index (BI), and the gait index (GI). Results: There were no significant predictors of early postoperative rehabilitation in the ID-IM group. In the ID-EM group, age, thoracic level, subtotal resection (STR), repeat surgery, and functional scale scores predicted the need for rehabilitation. In multivariable analysis, MMS (odds ratio (OR) 8.7; 95% confidence interval (CI): 2.37–32.44) and STR (OR 13.00; 95%CI: 1.56–107.87) remained independent predictors of rehabilitation need (area under curve, 92%). Despite their younger age, most patients with ID-IM tumors, especially ependymomas, required rehabilitation but improved quickly (KPS, BI, <i>p</i> < 0.001). Among ID-EM tumors, meningiomas were characterized by poorer preoperative function and low gross total resection (GTR) rates, but did not deteriorate neurologically after surgery. Patients with schwannoma and ID-EM ependymomas achieved the highest GTR rate and had the best function both before and after surgery. Conclusions: These results may be useful for estimating early rehabilitation needs after intradural tumor surgery and counseling patients before surgery about the expected postoperative course.https://www.mdpi.com/2076-3425/15/1/51intradural tumor surgeryfunctional statehistopathological subtyperehabilitation |
| spellingShingle | Stanisław Krajewski Jacek Furtak Monika Zawadka-Kunikowska Michał Kachelski Jakub Soboń Marek Harat Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study Brain Sciences intradural tumor surgery functional state histopathological subtype rehabilitation |
| title | Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study |
| title_full | Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study |
| title_fullStr | Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study |
| title_full_unstemmed | Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study |
| title_short | Factors Determining Rehabilitation Needs After Intradural Spinal Tumor Surgery: A Prospective Study |
| title_sort | factors determining rehabilitation needs after intradural spinal tumor surgery a prospective study |
| topic | intradural tumor surgery functional state histopathological subtype rehabilitation |
| url | https://www.mdpi.com/2076-3425/15/1/51 |
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