Thomas Noh1, Manuel S Vogt2, David W Pruitt3, Trent R Hummel4, Francesco T Mangano5,6. 1. Department of Neurological Surgery, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI, 48202, USA. 2. Department of Neurosurgery, Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA. 3. Department of Rehabilitation, Division of Pediatric Rehabilitation, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA. 4. Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA. 5. Department of Neurosurgery, Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA. Francesco.mangano@cchmc.org. 6. Department of Neurological Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, MLC 2016, 3333 Burnet Avenue, Cincinnati, OH, 44529, USA. Francesco.mangano@cchmc.org.
Abstract
PURPOSE: The Functional Independence Measure for children (WeeFIM) is a user-friendly functional outcomes tool that has been validated across other traditional functional scales. Historically, the significant neurologic and functional deficits of intramedullary spinal cord tumors (IMSCTs) have been monitored by coarse or overbearing functional outcomes tools that make it difficult to measure the slow improvement/decline seen in these patients. This study is the first to report WeeFIM outcomes on a series of IMSCTs with emphasis on an aggressive surgical strategy. METHODS: A retrospective review from 2005 to 2014 was performed for nine patients who underwent resective surgery for intramedullary spinal cord tumors with intraoperative ultrasound and neurophysiologic monitoring. WeeFIM scales were assessed at admission and discharge to evaluate changes in severity of disability and need for assistance. RESULTS: At the time of this submission, 7/9 patients are alive. The mean WeeFIM improvement was 27 points (8-50 points) with a mean WeeFIM efficiency of 2.0 points/day. CONCLUSIONS: The WeeFIM scale is an appropriate and useful scale for measuring postoperative improvements in patients with IMSCTs undergoing aggressive resective surgery. Attention to intraoperative spinal cord monitoring and prevention of spinal column instability may prevent morbidity related to surgery, and functional outcomes do not appear to be compromised by an aggressive surgical approach.
PURPOSE: The Functional Independence Measure for children (WeeFIM) is a user-friendly functional outcomes tool that has been validated across other traditional functional scales. Historically, the significant neurologic and functional deficits of intramedullary spinal cord tumors (IMSCTs) have been monitored by coarse or overbearing functional outcomes tools that make it difficult to measure the slow improvement/decline seen in these patients. This study is the first to report WeeFIM outcomes on a series of IMSCTs with emphasis on an aggressive surgical strategy. METHODS: A retrospective review from 2005 to 2014 was performed for nine patients who underwent resective surgery for intramedullary spinal cord tumors with intraoperative ultrasound and neurophysiologic monitoring. WeeFIM scales were assessed at admission and discharge to evaluate changes in severity of disability and need for assistance. RESULTS: At the time of this submission, 7/9 patients are alive. The mean WeeFIM improvement was 27 points (8-50 points) with a mean WeeFIM efficiency of 2.0 points/day. CONCLUSIONS: The WeeFIM scale is an appropriate and useful scale for measuring postoperative improvements in patients with IMSCTs undergoing aggressive resective surgery. Attention to intraoperative spinal cord monitoring and prevention of spinal column instability may prevent morbidity related to surgery, and functional outcomes do not appear to be compromised by an aggressive surgical approach.
Authors: R J Packer; J Ater; J Allen; P Phillips; R Geyer; H S Nicholson; R Jakacki; E Kurczynski; M Needle; J Finlay; G Reaman; J M Boyett Journal: J Neurosurg Date: 1997-05 Impact factor: 5.115
Authors: D D Allen; M J Mulcahey; S M Haley; M J Devivo; L C Vogel; C McDonald; T Duffy; R R Betz Journal: Spinal Cord Date: 2008-08-05 Impact factor: 2.772