ArticleBrain & spine2026
Determinants of clinical outcome and revision surgery in spinal tumors: Analysis of 344 procedures.
Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Spinal tumors present diagnostic and surgical challenges due to their anatomical and histological heterogeneity. Reliable determinants of postoperative outcome and revision surgery remain limited across mixed tumor cohorts. Research question: Which clinical, tumor-related and surgical factors predict postoperative neurological outcome and the need for revision surgery in patients undergoing spinal tumor resection? Material and methods: Single-center retrospective cohort of 344 resections in 326 patients during a 10-year period. Tumors were classified by anatomical compartment located intradural-extramedullary (45.3%), extradural (29.7%) or intramedullary (25.0%). Clinical outcome was defined as postoperative neurological outcome and revision surgery. Multivariate logistic regression was used to identify determinants of outcome. Results: Neurological improvement or stability was achieved in 84.6% of cases, with the best outcomes in intradural extramedullary tumors (90.3%). Revision surgery was required in 9.0% of cases. Gross total resection (GTR) was achieved in 71% and was the strongest positive determinator of favorable outcome (OR 1.9, p = 0.0266), while perioperative complications significantly reduced the likelihood of improvement (OR 0.6, p = 0.0230). Malignant histology and subtotal resection were associated with higher revision rates. Intraoperative neuromonitoring (IONM) showed a non-significant trend toward improved outcomes but was used more frequently in high-risk cases. Significant IONM deterioration occurred in 5.3% correlating with poorer long-term outcomes despite not determining immediate postoperative deterioration. Discussion and conclusion: Surgical outcome in spinal tumor patients is primarily determined by achieving safe GTR and minimizing perioperative complications. Tumor histology and anatomical location significantly influence prognosis. IONM remains valuable in complex cases.
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