Background Surgical resection of the lesions remains the main treatment method for most symptomatic spinal cord cavernous malformations (SCCMs) to eliminate the occupation and associated subsequent lifelong haemorrhagic risk. However, the timing of surgical intervention remains controversial, especially for patients in the acute stage after severe haemorrhage. Methods Patients diagnosed with SCCMs who were surgically treated between January 2002 and December 2021 were selected and retrospectively reviewed. The Modified McCormick Scale (MMS) was used to evaluate neurological and disability status. All medical information was reviewed, and all patients were followed up for at least 6 months. Results A total of 279 patients were ultimately included. With regard to long-term outcomes, 110 (39.4%) patients improved, 159 (57.0%) remained unchanged and 10 (3.6%) worsened. For patients with an MMS score of 2–5 on admission, in univariate and multivariate analyses, a ≤6 weeks period between onset and surgery (adjusted OR 3.211, 95% CI 1.504 to 6.856, p=0.003) was a significant predictor of improved MMS. Among 69 patients who first presented with severe haemorrhage, undergoing surgery within 6 weeks of the onset of severe haemorrhage (adjusted OR 4.901, 95% CI 1.126 to 21.325, p=0.034) was significantly associated with improvement of MMS score. Conclusion Surgical timing can influence the long-term outcome of SCCMs. For patients with symptomatic SCCMs, especially those with severe haemorrhage, early surgical intervention within 6 weeks can provide more benefit. Data are available on reasonable request.

中文翻译：

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严重出血性脊髓海绵状畸形患者的手术时机和长期结果

背景 手术切除病变仍然是大多数有症状的脊髓海绵状畸形（SCCM）的主要治疗方法，以消除职业和随后相关的终生出血风险。然而，手术干预的时机仍存在争议，特别是对于严重出血后的急性期患者。方法 选择2002年1月至2021年12月期间诊断为SCCM并接受手术治疗的患者进行回顾性分析。改良麦考密克量表（MMS）用于评估神经系统和残疾状态。所有医疗信息均经过审查，所有患者均接受至少 6 个月的随访。结果 最终共纳入279例患者。就长期结果而言，110 名患者（39.4%）有所改善，159 名患者（57.0%）保持不变，10 名患者（3.6%）恶化。对于入院时 MMS 评分为 2-5 分的患者，在单变量和多变量分析中，发病和手术之间 ≤6 周的时间（调整后 OR 3.211，95% CI 1.504 至 6.856，p=0.003）是病情改善的显着预测因子。彩信。在 69 名首次出现严重出血的患者中，在严重出血发生后 6 周内接受手术（调整后 OR 4.901，95% CI 1.126 至 21.325，p=0.034）与 MMS 评分的改善显着相关。结论 手术时机可以影响 SCCM 的长期结果。对于有症状的 SCCM 患者，尤其是严重出血的患者，6 周内早期手术干预可以带来更多益处。可根据合理要求提供数据。