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Incidence and predictors of kyphotic deformity following resection of cervical intradural tumors in adults: a population-based cohort study.
Acta Neurochirurgica ( IF 2.4 ) Pub Date : 2020-06-16 , DOI: 10.1007/s00701-020-04416-4
Charles Tatter 1, 2 , Alexander Fletcher-Sandersjöö 1, 2 , Oscar Persson 1, 2 , Gustav Burström 1, 2 , Per Grane 3 , Erik Edström 1, 2 , Adrian Elmi-Terander 1, 2
Affiliation  

BACKGROUND The first line of treatment for most cervical intradural tumors is surgical resection through laminotomy or laminectomy. This may cause a loss of posterior pulling force leading to kyphosis, which is associated with decreased functional outcome. However, the incidence and predictors of kyphosis in these patients are poorly understood. OBJECT To assess the incidence of posterior fixation (PF), as well as predictors of radiological kyphosis, following resection of cervical intradural tumors in adults. METHODS A population-based cohort study was conducted on adult patients who underwent intradural tumor resection via cervical laminectomy with or without laminoplasty between 2005 and 2017. Primary outcome was kyphosis requiring PF. Secondary outcome was radiological kyphotic increase, measured by the change in the C2-C7 Cobb angle between pre- and postoperative magnetic resonance images. RESULTS Eighty-four patients were included. Twenty-four percent of the tumors were intramedullary, and the most common diagnosis was meningioma. The mean laminectomy range was 2.4 levels, and laminoplasty was performed in 40% of cases. No prophylactic PF was performed. During a mean follow-up of 4.4 years, two patients (2.4%) required delayed PF. The mean radiological kyphotic increase after surgery was 3.0°, which was significantly associated with laminectomy of C2 and C3. Of these, C3 laminectomy demonstrated independent risk association. CONCLUSIONS There was a low incidence of delayed PF following cervical intradural tumor resection, supporting the practice of not performing prophylactic PF. Kyphotic increase was associated with C2 and C3 laminectomy, which could help identify at-risk patients were targeted follow-up is indicated.

中文翻译:

成人颈硬脑膜内肿瘤切除术后后凸畸形的发生率和预测因素:一项基于人群的队列研究。

背景技术对于大多数子宫颈硬膜内肿瘤的第一线治疗是通过椎板切开术或椎板切除术进行手术切除。这可能会导致后拉力的损失,导致后凸畸形,这与功能预后降低相关。但是,这些患者后凸畸形的发生率和预测因素知之甚少。目的评估成年人颈硬脑膜内肿瘤切除术后后固定(PF)的发生率以及放射性后凸的预测因子。方法对2005年至2017年间通过颈椎椎板切除术(有或没有行椎板成形术)行硬膜内肿瘤切除的成年患者进行了一项基于人群的队列研究。主要结果是需要PF的后凸畸形。次要结果是放射后凸增加,通过术前和术后磁共振图像之间C2-C7 Cobb角的变化测量。结果纳入患者84例。百分之二十四的肿瘤是髓内的,最常见的诊断是脑膜瘤。椎板切除术的平均范围为2.4级,在40%的病例中进行了椎板成形术。没有进行预防性PF。在平均4.4年的随访期间,两名患者(2.4%)需要延迟PF。术后平均放射后凸增加3.0°,这与C2和C3椎板切除术显着相关。其中,C3椎板切除术显示出独立的风险关联。结论宫颈硬膜内肿瘤切除术后延迟性PF发生率低,支持不进行预防性PF的做法。
更新日期:2020-06-16
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