脊髄海綿状血管腫の治療

抄録

Background: Since the etiology of spinal cord cavernous malformations (CMs) is unclear, it is difficult to establish an optimal management strategy for spinal cord CMs.

Objective: To describe conservative and surgical management strategies for spinal cord CMs.

Materials and methods: We performed a retrospective study of patients diagnosed with spinal cord CMs. The neurological symptoms and Modified McCormick Scale scores of the selected patients were recorded. When patients experienced acute onset of hemorrhage or debilitating symptoms, the timing of surgery was determined by a shared decision-making process involving both physicians and patients.

Results: We identified a total of 12 patients (7 [58.3%] male; mean age of 38.0 years). Seven patients underwent microsurgical removal. During follow-up with conservative treatment, six patients underwent surgery for worsening of symptoms, one patient showed worsening of neurological symptoms but did not undergo surgery, and four patients showed no worsening of symptoms. The mean duration from presentation to subsequent hemorrhage or worsening of symptoms was 15.2 months, including asymptomatic recurrence. No patient experienced subsequent hemorrhage after surgical resection. Five patients (71.4%) within the surgical group showed improvements in their neurological state, two patients (28.6%) showed no change, and none experienced worsening of the symptoms.

Conclusions: Surgical treatment of spinal cord CMs did not lead to recurrence of hemorrhage or exacerbation of neurological symptoms.