Long-Term Patient Reported Outcomes Following Surgery for Spinal Intradural Tumours

Although Intradural Extramedullary and Intradural Intramedullary tumours can have varied prognoses depending on the surgical features of the tumour and the histological subtype and grade, the range of possible neurological outcomes following surgery is a wide-ranging commonality. The short-term clinical outcomes for these tumours are well studied and generally understood to be favourable, particularly for Intradural Extramedullary tumours. Several studies have identified multiple factors that influence post-operative surgical outcomes, including pre-operative neurological grade, upper thoracic location and longitudinal extension of the tumour.

While longer-term studies assessing the surgical and neurological outcomes following treatment for PSIDT exist, the long-term impact on patient reported HRQoL is less well studied8. For example, one study by Seppala et al. retrospectively contacted 187 patients treated for spinal schwannoma with a median follow-up of 12.8 years. A non-validated symptom questionnaire was used to identify residual symptoms and long-term operative complications, but no patient reported HRQoL assessments were performed. In adults, one study by Xiao et al. did seek to assess HRQoL outcomes in 45 patients with Intradural Intramedullary tumours , although the duration of follow up was 22 months. This was performed using the EuroQol 5-Dimensions (EQ-5D), Pain disability questionnaire (PDQ) and Patient Health Questionnaire-9 (PHQ9).

The objective of this study is to identify the long-term impact of PSIDT tumours and their treatment on patient HRQoL for those managed at the Walton Centre NHS Foundation Trust (WCFT), which provides tertiary care to a catchment population of 3.5 million so will manage many patients with these rare tumours. Additionally, the availability of Spine-Tango allows the identification of patients spanning a long duration of follow up. By encompassing a broad anatomical subset, we hope that this will be more sensitive to factors influencing PROs. Additionally, we aim to capture trends that may be more meaningful to patients by performing this long-term follow up. No studies have so far attempted to assess longer term patient reported HRQoL outcomes in this patient group. This study will better identify patient priorities, guide future research directions and holistic care planning. This will be achieved through a cross-sectional cohort study, which will evaluate PROs using five validated questionnaires at a single time point following surgery. These PRO measures will assess HRQoL. The definition of PRO includes the use of subjective measures such as those used for assessment of HRQoL