Comparing laminectomy and unilateral hemilaminectomy in spinal hemangioblastoma resection: A multicenter study.
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Wach Johannes, Basaran Alim Emre, Vychopen Martin, Tihan Tarik, Wostrack Maria, Butenschoen Vicki M, Meyer Bernhard, Siller Sebastian, Schmidt Nils Ole, Onken Julia, Vajkoczy Peter, Santos Alejandro N, Rauschenbach Laurèl, Dammann Philipp, Sure Ulrich, Klingler Jan-Helge, Doria-Medina Roberto, Beck Jürgen, Blaß Bianca-Ioana, Gizaw Christine Juliane, Hohenhaus Romina, Krieg Sandro M, Alhalabi Obada T, Klein Lukas, Thomé Claudius, Kögl Nikolaus, Kunert Przemyslaw, Czernicki Tomasz, Pantel Tobias, Middelkamp Maximilian, Eicker Sven Oliver, Kattaa Ahed H, Park David J, Chang Steven D, Kilinc Fatma, Czabanka Marcus, Güresir Erdem
Аннотация
MATERIAL AND METHODS: This retrospective international multicenter study included 280 primary sHB patients from 13 neuro-oncological centers who underwent either laminectomy (n = 125) or hemilaminectomy (n = 155). The endpoints were the extent of resection, functional outcomes at 12 months, and postoperative bleeding requiring retreatment. Multivariable logistic regression analysis was performed to determine independent risk factors associated with these outcomes.
RESULTS: The rate of complete resection was similar between both surgical approaches, with 86.4% in the laminectomy group and 90.3% in the hemilaminectomy group (p = 0.35). Independent predictors of incomplete resection included preoperative modified McCormick >2 (OR: 4.29, p = 0.001), combined intra- and extramedullary tumor location (OR: 2.91, p = 0.03), and cervical or thoracic tumor location (OR: 3.38, p = 0.01). Functional outcomes at 12 months did not differ significantly between the laminectomy- and hemilaminectomy-groups (p = 0.97). Postoperative bleeding was more frequently observed in tumors involving two or more spinal segments (OR: 14.6, p = 0.01). The choice of surgical approach did not impact the incidence of postoperative bleeding (p = 0.55).
CONCLUSION: Laminectomy and hemilaminectomy result in comparable outcomes of sHB. Tumors affecting multiple spinal segments are associated with an increased risk of postoperative bleeding, while combined intra- and extramedullary growth, impaired preoperative functioning and non-lumbar location were associated with incomplete resection. Given the comparable outcomes, the selection of the surgical approach may be guided by surgeon preference and individual patient anatomy.