• Laurèl Rauschenbach, Alejandro N Santos, Adrian Engel, Angelina Olbrich, Arnau Benet, Yen Li, Börge Schmidt, Oliver Gembruch, Neriman Özkan, Ramazan Jabbarli, Karsten H Wrede, Adrian Siegel, Michael T Lawton, Ulrich Sure, and Philipp Dammann.
• Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany. laurel.rauschenbach@uk-essen.de.
• Eur Spine J. 2023 May 1; 32 (5): 171417201714-1720.

PurposeSpinal cavernous malformations (SCM) present a risk for intramedullary hemorrhage (IMH), which can cause severe neurologic deficits. Patient selection and time of surgery have not been clearly defined.MethodsThis observational study included SCM patients who underwent surgery in our department between 2003 and 2021. Inclusion required baseline clinical factors, magnetic resonance imaging studies, and follow-up examination. Functional outcome was assessed using the Modified McCormick scale score.ResultsThirty-five patients met the inclusion criteria. The mean age was 44.7 ± 14.5 years, and 60% of the patients were male. In univariate analysis, the unfavorable outcome was significantly associated with multiple bleeding events (p = .031), ventral location of the SCM (p = .046), and incomplete resection (p = .028). The time between IMH and surgery correlated with postoperative outcomes (p = .004), and early surgery within 3 months from IMH was associated with favorable outcomes (p = .033). This association remained significant in multivariate logistic regression analysis (p = .041).ConclusionsRemoval of symptomatic SCM should be performed within 3 months after IMH when gross total resection is feasible. Patients with ventrally located lesions might be at increased risk for postoperative deficits.© 2023. The Author(s).

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