Outcomes of Surgical Management and Risks of Recurrence of Symptomatic Spinal Hemangiomas: A Multicenter Series of 68 Cases
Notice bibliographique
Résumé
Introduction Spinal hemangiomas are the most common tumor of the spine, being identified in 2 to 27% of patients at autopsy and on radiographic and magnetic resonance imaging studies. The majority of spinal hemangiomas are identified incidentally with only 1% presenting with symptoms, including pain, pathologic fracture, or neurologic compromise. Because of the rarity of symptomatic presentation, optimal surgical treatment of, and risk factors for local recurrence and mortality associated with, symptomatic spinal hemangiomas remain unclear. This multicenter cohort study aims to quantify rates of local recurrence and mortality following surgical treatment of symptomatic spinal hemangiomas and to identify prognostic variables for local disease control and death. Patient and Methods: AOSpine knowledge forum tumor investigators created an ambispective database of surgically treated patients with symptomatic spinal hemangiomas. Patient data pertaining to demographics, clinical presentation, diagnosis, treatment, cross-sectional survival, local recurrence, and perioperative morbidity were collected. Tumors were classified according to Enneking and Weinstein–Boriani–Biagini. Descriptive statistics were summarized and Kaplan–Meier curves illustrated mortality and recurrence. Fisher exact and log-rank tests identified prognostic variables for recurrence and mortality. Results Between 1996 and 2012, 68 patients (mean age = 51 years, SD = 16), 43 females and 25 males, underwent surgical treatment for a spinal hemangioma with 23% ( n = 13) classified as benign aggressive. Epidural tumor extension was present in 55% of patients ( n = 33). Pain was a presenting symptom in 82% ( n = 54), 31% ( n = 20) had a pathologic fracture, and 37% ( n = 24) were neurologically compromised. Overall, 23 patients (35%) underwent preoperative embolization. Enneking appropriate surgery was performed in 79% of patients ( n = 44). Adjuvant radiotherapy was employed in 10% of patients ( n = 7). The local recurrence rate was 3% ( n = 2) with no recurrences in patients undergoing marginal or wide resection. Mortality because of the spinal hemangioma was not observed during the study period (mean follow-up = 3.9 years, SD = 3.8). Prior subtotal intralesional resection was performed in one of the two patients who had a local recurrence. Conclusion This is the largest multicenter surgical cohort of spinal hemangiomas. Although symptomatic spinal hemangiomas frequently present with epidural disease and neurologic compromise, they remain a benign tumor. Thus, formal en bloc resection, with an associated risk and increased morbidity, is not required, and excellent rates of local control and long-term survival can be obtained when strict oncologic treatment principles are followed during the index surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».