J Neurol Surg B Skull Base 2016; 77 - PO-02
DOI: 10.1055/s-0036-1592648

Specific Features of Surgical Treatment of Skull Base Tumors Invasing the Craniovertebral Junction

Alexey Shkarubo 1, Dmitriy Andreev 1, Nikolay Konovalov 2, Petr Zelenkov 2, Konstantin Koval 1, Ilia Chernov 3
  • 1Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russian Federation
  • 2Department of Spinal surgery, the N.N. Burdenko Neurosurgery Institute, Moscow, Russian Federation
  • 3The I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation

Objective: Optimization of surgical treatment of skull base tumors, invasing the craniovertebral junction (CVJ).

Methods: Comparative analysis of two groups of patients was performed. The study group included 28 patients with skull base and CVJ chordomas (initial instability—13 patients), who underwent a simultaneous operation—occipitospondylodesis and tumor removal (transoral and combined transoral and transnasal approach). The control group included 21 patients with the same nosology (operation without occipitospondylodesis).

Results: In the study group, the number of radically removed tumors was 16.7%, subtotally—75%, partially—8.3%. Clinical sign changes in early postoperative period in study group: improvement—75%, no changes—17.8%, impairment—7.2%. In control group: improvement—52.4%, no changes—38.1%, impairment—9.5%. The number of postoperative complications (liquorrhea and meningitis) is higher in study group (more radical tumor removal). Using of novel surgical technologies helped to increase 3-year survival from 38% in control group to 78.6% in study group and 5-year survival from 23.8% in control group to 78.6% in study group.

Conclusion: Using of novel surgical technologies (simultaneous operation occipitospondylodesis [1st step] and tumor removal [2nd step) in surgery of skull base and CVJ tumors, causing CVJ instability (initial or postoperative) helps to increase the number of radically removed tumors, to speed up the rehabilitation process and to improve life quality of patients.