Improvement in Quality of Life Following Surgery for Intradural Extramedullary Tumors: A Prospective Evaluation of Patient Reported Outcomes. (16th November 2020)

• Record Type: Journal Article
• Authors: Newman, William; Berry-Candelario, John; Villavieja, Jemma; Reiner, Anne; Laufer, Ilya; Bilsky, Mark H; Barzilai, Ori
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_752
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Historically, symptomatic intradural extramedullary (IDEM) spine tumors have been managed with surgical resection. However, there are minimal robust data regarding patient reported outcomes (PROs) following treatment of symptomatic lesions. Moreover, there are increasing reports of radiosurgical management of these lesions without robust health related quality of life (HRQoL) data. METHODS: Prospective, single-center observational cohort study of patients with intradural extramedullary spine tumors undergoing surgical resection. Pre and post-operative Brief Pain Index (BPI) and MD Anderson Symptom Inventory (MDASI) questionnaires were used to quantitatively assess their symptom control after surgical intervention. Matched pairs were analyzed with the Wilcoxon Signed-Rank test. RESULTS: 57 patients met inclusion criteria with both pre- and post-operative PROs. There were 35 schwannomas, 18 meningiomas, 2 neurofibromas, 1 paraganglioma, and 1 mixed schwannoma/neurofibroma. Most patients were ASIA E (93%) with high grade spinal cord compression (77%), and underwent either a 2 or 3 level laminectomy (84%). Surgical resection resulted in statistically significant improvement in all three composite BPI constructs of Pain Severity, Pain Interference, and Overall Patient Pain Experience ( P < .0001). Surgical resection resulted in statistically significant improvements in all composite scores for the MDASI CORE Symptom Severity, Spine Tumor, and Disease Interference constructs ( P < .01). Three patients (5%) had postoperative complications requiring surgical interventions (2 wound revisions and 1 ventriculo-peritoneal shunt). CONCLUSION: Surgical resection of IDEM spine tumors provides rapid, significant and durable improvement in PROs.