Predicting outcomes in spinal hemangioblastoma surgery: Role of post-operative neurological status

Background: Spinal hemangioblastomas are rare, highly vascularized tumors that most frequently occur in patients between 30 and 50 years of age. Treatment often requires the input of neurosurgeons, neuroradiologists, and oncologists to optimize outcomes. Methods: We retrospectively evaluated 20 patients with spinal hemangioblastomas undergoing surgery at a tertiary care center (2010–2020). Our question was which prognostic factors best correlated with functional outcome (i.e., based on the modified McCormick scale). Results: Patients averaged 38.9 ± 12.54 years of age. Nine patients (45%) had von Hippel–Lindau (VHL) disease, and 50% had thoracic lesions. Most patients (80%) underwent surgical resection only, while 20% received adjuvant radiosurgery. Functional improvement or no change in neurological function was seen in 80% of patients. We found the post-operative McCormick grades best predicted/correlated with outcome, whereas the pre-operative McCormick grade, VHL status, and other variables did not. Conclusion: Post-operative neurological status based on McCormick grades was the best predictor of long-term outcome.