1077 Operative Management and Outcomes in Spinal Hemangioblastoma: A Multi-institutional Case Series of 59 Patients

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INTRODUCTION: Hemangioblastoma is a rare benign neoplasm that accounts for 2-5% of all spinal cord tumors and is associated with von-Hippel Landau (VHL) disease in about 25-30% of patients. Symptomatic spinal hemangioblastomas are typically managed with en bloc microsurgical resection, but the infrequent nature of these lesions has limited the detailed characterization of reported management and surgical outcomes in the literature. METHODS: We retrospectively reviewed all patients with pathology-proven spinal hemangioblastoma. We collected information about demographics, preoperative symptoms and imaging, intraoperative characteristics, and postoperative course. We analyzed what variables influence postoperative changes in motor scores and McCormick scores. RESULTS: We included 59 patients (35 sporadic, 24 VHL). The average age of diagnosis was 48.7 (± 16.1) for sporadic tumors and 35.1 (± 12.6) for those associated with VHL (p = 0.001). Most tumors were cervical (46.6%) or thoracic (34.5%) and both intradural (93.2%) and intramedullary (71.2%). Most patients (69.5%) had multiple spinal tumors. The average lesion volume was 0.98 (± 1.1) cm3. The average symptom duration before surgery was 24.7 (± 73.2) months. Adjuvant therapies included radiation (6.8%) and chemotherapy (1.7%). At 1 month postoperatively, 4.4% had motor loss in any muscle group and 31.1% had motor gain, while 18.6% had a decreased McCormick score and 28.8% had an improved score at 1 month. While 72.9% of patients had numbness/paresthesia preoperatively, only 59.3% did at 1 month. Duration of pre-operative symptoms and time from diagnosis to surgery were not found to influence outcomes. CONCLUSIONS: Overall, surgical planning should be guided by symptom management. In this population, duration of preoperative symptoms and timing of surgery did not influence post-operative functional outcomes.

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