gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Surgical management of spinal cord cavernomas

Meeting Abstract

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  • Vesna Malinova - Department of Neurosurgery Göttingen; Department of Neurosurgery Aachen
  • Veit Rohde - Department of Neurosurgery Göttingen; Department of Neurosurgery Aachen
  • Dorothee Mielke - Department of Neurosurgery Göttingen; Department of Neurosurgery Aachen

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.13.04

doi: 10.3205/14dgnc342, urn:nbn:de:0183-14dgnc3422

Published: May 13, 2014

© 2014 Malinova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Spinal cord cavernomas can be asymptomatic; however, if they bleed they are often associated with severe neurological deficits. Spinal cord cavernomas are infrequent, which might explain that larger institutional series are lacking. After having operated 35 spinal cavernomas, we feel encouraged to report our operative strategies as well as the postoperative long-term outcome.

Method: We retrospectively identified 35 patients with symptomatic intramedullary cavernoma, who underwent surgical treatment. Pre- and postoperative clinical findings, imaging data, cavernoma location, type of surgical approach and surgery-associated complications were evaluated.

Results: The mean age of the patients was 49 yrs (18–80). There were 18 females and 17 males. Sensory deficits were found in 80% of the patients, motor deficits in 34% and bladder dysfunction in 26%. To reach medially located cavernoma, median myelotomy via laminectomy/laminoplasty was performed in 14% of the patients. For laterally located cavernoma myelotomy at the area of the dorsal root entry via hemilaminectomy was done in 63%. In 20%, the laterality of the location guided the bony approach in patients with exophytic cavernoma. In 1 patient with ventrally located cavernoma, corporectomy and cage implantation was performed. After the operation 54% of the patients experienced worsening of the preoperative symptoms, in 14% an improvement was seen and in 32% the symptoms remained unchanged. After a mean follow-up of 6 months, an improvement was seen in 54% of the patients and the rate of neurological worsening dropped to 9%.

Conclusions: Defining the exact location of the cavernoma in relation to the pial surface is essential for guidance of the bony approach and the area of myelotomy. In the majority of the patients, a limited approach is adequate for successful resection of symptomatic cavernoma with a good long-term outcome. However, the rate of transient neurological worsening is substantial.