European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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To determine the frequency of major complications and identify related risk factors in surgery for hypervascular spinal tumors after preoperative selective arterial embolization. ⋯ Major complications in surgery for hypervascular spinal tumors after embolization are prevalent. Risk factors identified in this study are useful prognostic indicators when considering surgical treatment combined with embolization.
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Spinal intradural extramedullary (IDEM) schwannoma diagnosed by magnetic resonance (MR) imaging is sometimes detected incidentally. Because the natural history of spinal IDEM schwannoma has not been established well, questions remain regarding whether small and asymptomatic tumour has to be removed. We aimed to assess the natural history of spinal schwannoma diagnosed by MR imaging using an accurate and reliable method. ⋯ Spinal probable IDEM schwannoma grew 5.45% of the tumour volume annually and can be divided into growing and stable tumours. The tumour that grows≥2.5% of volume per year needs a careful inspection because it may be not benign schwannoma and keep growing continuously.
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Estimating the survival time of patients with spinal metastases based on pre-treatment parameters is important for the best choice of therapy. Following two previous studies, this sequel analyzes possible changes in the impact of various parameters and scoring systems and includes a comparison to the previous dataset for the purpose to find the most predictive parameters and scores for this patient group. ⋯ The Bauer modified score has shown consistent impact on predicting the remaining survival in patients with spinal metastases and is simultaneously simple in clinical use.
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Age-related loss of functional muscle mass is associated with reduced functional ability and life expectancy. In disseminated cancer, age-related muscle loss may be exacerbated by cachexia and poor nutritional intake, increasing functional decline, morbidity and accelerate death. Patients with spinal metastases frequently present for decompressive surgery with decision to operate based upon functional assessment. A subjective assessment of physical performance has, however, been shown to be a poor indicator of life expectancy in these patients. We aimed to develop an objective measure based upon lean muscle mass to aid decision making, in these individuals, by investigating the association between muscle mass and 1-year survival. ⋯ Death within 1 year in individuals with spinal metastases is related to lean muscle mass at presentation. Assessment of lean muscle mass may inform decision to operate in patients with spinal metastases.