gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Is S100b an additional marker for long-term outcome in intradural spinal cord surgery?

S100b als zusätzlicher Marker zur Prognose des Langzeitverlaufs nach intraduralen spinalen Tumoroperationen

Meeting Abstract

  • corresponding author C. Heukamp - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt/Main
  • A. Szelényi - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt/Main
  • G. Marquardt - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.02.11

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc220.shtml

Veröffentlicht: 11. April 2007

© 2007 Heukamp et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Despite the close correlation between intraoperative changes in Motor (MEPs) and Somatosensory Evoked Potentials (SEPs; “EPs”) and postoperative clinical status, it is difficult to distinguish transient versus permanent neurological deficit. This study assesses, whether S100b – a glial derivated protein – might be helpful as an additional marker in intradural and intramedullary spinal tumor surgery to predict long-term outcome.

Methods: Significant intraoperative EP-changes (SEP-amplitude decrement >50% or an MEP loss); the S100b blood serum concentration on perioperative days -1, 0, 1, 3 and 5 (pathological increase ≥0,09 µg/l ≥2 postoperative days) and the clinical status (postoperatively at day 1 and >year after discharge) were evaluated and correlated.

Results: 19 patients (7 m, 12 f; 54±32 years) undergoing intramedullary (6) or intradural (13) cervical or thoracic spinal surgery were studied. 10/19 (53%) patients had no changes of EPs and S100b with a long-term clinical improvement. 4/19 (21%) patients had changes of EPs and S100b with a permanent neurological deterioration in 3 patients and delayed clinical improvement in one patient. 3/19 (16%) patients had only an S100b increase with an unchanged (1) or improved long-term outcome (2). 2/19 (10%) patients had EP changes and an unchanged S100b with either an unchanged or worsened clinical outcome.

Conclusions: Intraoperatively unchanged EPs followed by a normal S100b may predict neurological improvement. In case of unchanged EPs, an increased S100b may imply a relatively constant progression, not indicating a relevant spinal cord lesion. Increased S100b and EP-changes are likely to be followed by a long-term neurological deficit indicating a relevant spinal cord lesion. In summary, the combined use of S100b and EPs may be helpful in the evaluation of the severity of adverse spinal cord damage following surgery.