gms | German Medical Science

Introduction: Spinal emergency decompression for acute transversal syndrome caused by intraspinal tumour masses is a frequent neurosurgical procedure. To evaluate factors influencing outcome, spinal decompression procedures performed at the Klinik für Neurochirurgie, Nordstadtkrankenhaus Hannover between January 2003 and September 2007 were analyzed.

Material and methods: All patients operated on for spinal decompression because of transversal syndrome caused by an intraspinal tumour mass were retrospectively analyzed. Particular respect was given to analyze factors influecing the outcome such as duration of symptoms, extent of neurological deficit at time of surgery and age of the patients. Deficits caused by pathologic fractures were excluded.

Results: 61 patients with intraspinal tumour masses underwent surgical decompression between 2003 and 2007 at the Nordstadtkrankenhaus Hannover. Patient consisted of 32 males and 28 females, the patient age scored 67 years with a range of 34 up to 81 years. Tumours were primarily located in the caudal thoracic spine followed by lumbar spine and upper thoracic as well as cervical spine. 48 patients (79%) benefit from the procedure and showed postoperativ neurological improvement. Only 7 patients (11%) required another procedure for spinal stabilization. The outcome correlated closely with the degree of preoperative neurological deficits, the duration of symptoms and the age pf the patients. However, one paraplegic patient recovered completely from emergency decompression despite paraplegia since 24 hours at the time of decompression.

Conclusion: Spinal decompression is a successful emergency option in transversal syndrome caused by intraspinal tumours. The outcome correlates with the patient’s age, neurological status and duration of symptoms. However, in rare cases even paraplegic patients might regain good functional status that emergency decompression should always be considered.