Our Summary
The study looked at the long-term results of two treatments for a condition called intramedullary spinal cord cavernous malformations (ISCCMs), which are abnormal clusters of blood vessels in the spinal cord. The researchers analyzed 21 previous studies that included a total of 1091 patients.
The two treatments they looked at were surgical removal of the malformation and conservative treatment, which means managing symptoms but not removing the malformation. Most of the patients (92.1%) had surgery, and in nearly all of these cases, the surgeons were able to remove all or most of the malformation.
The researchers found that over the long term, surgery led to improved symptoms in 36.9% of patients, while symptoms stayed the same in 55.8% of patients and got worse in 7.3% of patients. In the group that received conservative treatment, 21.7% of patients saw an improvement in symptoms, while symptoms stayed the same in 69.6% of patients and got worse in 8.7% of patients.
The researchers also found that patients were more likely to have a good long-term outcome if they only had one malformation, if they had surgery within the first three months of symptoms appearing, and if their symptoms improved after surgery.
Based on these findings, the researchers recommend that when possible, patients with ISCCM should have surgery within the first three months of experiencing symptoms. They also suggest that more research is needed to understand when conservative treatment might be the best option.
FAQs
- What are intramedullary spinal cord cavernous malformations (ISCCMs) and what treatments were studied for this condition?
- What were the findings of the study regarding the effectiveness of surgical removal versus conservative treatment of ISCCMs?
- What recommendations did the researchers make for patients with ISCCMs based on the study’s findings?
Doctor’s Tip
A helpful tip a doctor might tell a patient about spinal surgery is to seek treatment as soon as possible if experiencing symptoms related to intramedullary spinal cord cavernous malformations (ISCCMs). Early intervention with surgery within the first three months of symptoms appearing can lead to better long-term outcomes. It is also important to follow post-operative care instructions and attend follow-up appointments to monitor progress and address any concerns.
Suitable For
Patients with intramedullary spinal cord cavernous malformations (ISCCMs) who are experiencing symptoms such as pain, weakness, numbness, or difficulty walking are typically recommended spinal surgery. Patients who have only one malformation, experience symptoms within the first three months, and show improvement in symptoms after surgery are more likely to have a good long-term outcome. However, more research is needed to determine when conservative treatment may be the best option for these patients.
Timeline
Before spinal surgery, a patient may experience symptoms such as back pain, weakness, numbness, or difficulty walking. They may undergo diagnostic tests such as MRI or CT scans to determine the cause of their symptoms. The patient will then meet with their healthcare provider to discuss treatment options, including the risks and benefits of surgery.
After spinal surgery, the patient will typically stay in the hospital for a few days for monitoring and recovery. They may experience pain and discomfort at the surgical site, and will be prescribed pain medication to manage this. Physical therapy may be recommended to help the patient regain strength and mobility in their spine. Follow-up appointments with the surgeon will be scheduled to monitor the patient’s progress and address any concerns or complications that may arise. Over time, the patient should experience improvements in their symptoms and overall quality of life.
What to Ask Your Doctor
Some questions a patient should ask their doctor about spinal surgery for intramedullary spinal cord cavernous malformations (ISCCMs) include:
- What are the potential risks and benefits of surgical removal of the malformation compared to conservative treatment?
- How likely is it that surgery will improve my symptoms, and what are the potential outcomes in terms of symptom improvement, stability, or worsening?
- What is the success rate of surgery in removing all or most of the malformation, and how does this impact long-term outcomes?
- Are there any specific factors about my case, such as the number of malformations or timing of symptoms, that may impact the success of surgery?
- What is the recommended timing for surgery in cases of ISCCMs, and how important is it to have surgery within the first three months of symptoms appearing?
- Are there any alternative treatment options to consider, and how do these compare in terms of potential outcomes and risks?
- What is the recovery process like after spinal surgery for ISCCMs, and what can I expect in terms of long-term outcomes and symptom management?
- Are there any specific post-operative care or rehabilitation strategies that are recommended for patients undergoing spinal surgery for ISCCMs?
- Are there any ongoing research studies or clinical trials related to the treatment of ISCCMs that I should be aware of?
- How can I best prepare for surgery, and what steps should I take to ensure the best possible outcome?
Reference
Authors: Asimakidou E, Meszaros LT, Anestis DM, Tsitsopoulos PP. Journal: Eur Spine J. 2022 Nov;31(11):3119-3129. doi: 10.1007/s00586-022-07332-6. Epub 2022 Aug 6. PMID: 35931791