Main Article Content

Abstract

The lack of clarity about the opportunities for significant neurologic improvement, coupled with the risk of severe postoperative complications, decompression surgery for patients with giant tumors in the cervical spine accompanied by long-lasting advanced neurological deficits places a heavy moral burden on surgeons. Here we report a three-year follow-up after surgery for an immense spinal neurofibroma in which the patient was bedridden for the past fifteen years. Our findings suggest surgery remains beneficial for patients without major postoperative complications.

Keywords

Cost of illness Neurofibroma Paraplegia Spinal cord neoplasms

Article Details

How to Cite
Saekhu, M., Susanto, E., Ashari, S., & Nugroho, S. (2022). Is there any benefit from surgery for giant-dumbbell spinal tumors with prolonged paraplegia and joints contractures? a rare case report. Neurologico Spinale Medico Chirurgico, 5(1), 16-21. https://doi.org/10.36444/nsmc.v5i1.174

References

  1. Wancata LM, Hinshaw DB. Rethinking autonomy: decision making between patient and surgeon in advanced illnesses. Annals of Translational Medicine. 2016;4(4):14. DOI: 10.3978/j.issn.2305-5839.2016.01.36
  2. Quraishi NA, Rajagopal TS, Manoharan SR, et al. Effect of timing of surgery on neurological outcome and survival in metastatic spinal cord compression. Eur Spine J 2013;22(6):1383-8. DOI: 10.1007/s00586-012-2635-y
  3. Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus Delayed Decompression for Traumatic Cervical Spinal Cord Injury: Results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS ONE. 2012;7(2):e32037. DOI: 10.1371/journal.pone.0032037
  4. Æsøy MS, Solvang SEH, Grønning M, et al. Epidemiology of persistent iatrogenic spinal cord injuries in Western Norway. Brain and Behavior. 2016;6:1–6. e00522. DOI: 10.1002/brb3.522
  5. Vidal PM, Karadimas SK, Ulndreaj A, et al. Delayed decompression exacerbates ischemia-reperfusion injury in cervical compressive myelopathy. JCI Insight. 2017;2(11):e92512. DOI: 10.1172/jci.insight.92512
  6. Zimmermann CJ, Taylor LJ, Tucholka JL, et al. The association between factors promoting non-beneficial surgery and moral distress: A national survey of surgeons. Ann Surg. 2020. DOI: 10.1097/SLA.0000000000004554
  7. Giacomini L, Mathias RN, Joaquim AF, et al. Is there a right time for surgery in paraplegic patients secondary to nontraumatic spinal cord compression?. Einstein (Sao Paulo). 2012;10(4):508-11. DOI: 10.1590/s1679-45082012000400020
  8. Laufer I, Zuckerman SL, Bird JE, et al. Predicting neurologic recovery after Surgery in patients with deficits secondary to MESCC: Systematic review. Spine. 2016;41(Suppl 20):S224-30. DOI: 10.1097/BRS.0000000000001827
  9. Fan Y, Zhou X, Wang H, et al. The timing of surgical intervention in the treatment of complete motor paralysis in patients with spinal metastasis. Eur Spine J. 2016;25:4060–6. DOI: 10.1007/s00586-016-4406-7
  10. Dakson A, Christie SD. Role of decompressive surgery in disorders associated with spinal cord lesions. In: Topics in Paraplegia. InTech. 2014. DOI: 10.5772/58408
  11. Saekhu M, Chairani-Siregar N, Gunawan K, et al. Nine-segment laminectomy is safe for the resection of a schwannoma extending from C-2 to T-3: A rare case report. Med J Indones. 2020;29(3):326-31. DOI: 10.13181/mji.cr.192844
  12. Belakhoua SM, Rodriguez FJ. Diagnostic pathology of tumors of peripheral nerve. Neurosurg. 2021;88:443-56. DOI:10.1093/neuros/nyab021
  13. Birol-Sarica F. Surgical principles for spinal and paraspinal neurofibromas. In: Roy-Morgan L, Birol-Sarica F, editors. Brain and Spinal Tumors - Primary and Secondary. IntechOpen: EBook. 2020; Chapter 6. DOI: 10.5772/intechopen.77682
  14. Safaee MM, Lyon R, Barbaro NM, et al. Neurological outcomes and surgical complications in 221 spinal nerve sheath tumors. J Neurosurg Spine. 2017;26(1):103-11. DOI: 10.3171/2016.5.SPINE15974
  15. Sridhar K, Ramamurthi R, Vasudevan MC, et al. Giant invasive spinal schwannomas: Definition and surgical management. J Neurosurg. 2001;94(2 Suppl):210-5. DOI: 10.3171/spi.2001.94.2.0210
  16. Yu NH, Lee SE, Jahng TA, et al. Giant invasive spinal schwannoma: Its clinical features and surgical management. Neurosurgery. 2012;71(1):58-66. DOI: 10.1227/neu.0b013e31824f4f96
  17. Kaptain GJ, Simmons NE, Replogle RE, et al. Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg. 2000;93(2 Suppl):199-204. DOI: 10.3171/spi.2000.93.2.0199
  18. Kim SH, Doh JW, Yoon SM, et al. Huge schwannoma extended from craniocervical junction to upper thoracic spine. J Korean Neurosurg Soc. 2003;34(6):589–92.
  19. Cao J, Zhang J, Yang D, et al. Multivariate analysis of factors associated with kyphotic deformity after laminoplasty in cervical spondylotic myelopathy patients without preoperative kyphotic alignment. Sci Rep. 2017;27(7):43443. DOI: 10.1038/srep43443
  20. Lee SY, Lee SH, Tan JHH, et al. Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients: a retrospective medical record review. BMC Health Serv Res. 2018;18(1):5. DOI: 10.1186/s12913-017-2817-8
  21. Khan NA, Quan H, Bugar JM, et al. Association of postoperative complications with hospital costs and length of stay in a tertiary care center. J Gen Intern Med. 2006;21(2):177–80. DOI: 10.1007/s11606-006-0254-1
  22. Daniels AH, Hart RA, Hilibrand AS, et al. Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery. Global Spine J 2017;7(1 Suppl):84S-90S. DOI: 10.1177/2192568216688188
  23. Yang T, Wu L, Deng X, et al. Delayed neurological deterioration with an unknown cause subsequent to surgery for intraspinal meningiomas. Oncol Lett. 2015;9(5):2325-30. DOI: 10.3892/ol.2015.3024
  24. Patil CG, Patil TS, Lad SP, et al. Complications and outcomes after spinal cord tumor resection in the United States from 1993 to 2002. Spinal Cord. 2008;46:375–9. DOI: 10.1038/sj.sc.3102155
  25. Wang X, Gao J, Wang T, et al. The long-term outcome after resection of upper cervical spinal cord tumors: Report of 51 consecutive cases. Sci Rep. 2018;8:14831. DOI: 10.1038/s41598-018-33263-8