This article shows the long-term advantage of @entity602 over partial resection and over non-surgical treatment for @entity1 with asymptomatic @entity362 . The classification, embryogenesis, and technique of total resection of complex @entity362 are described. The 20-year outcome of 315 @entity1 who had total resection is measured by overall progression-free survival (PFS, Kaplan-Meier), and by subgroup Cox multivariate hazard analysis for the influence of four variables: @entity362 type, symptoms, prior surgery, and post-operative cord-sac ratio. These results are compared to 116 @entity1 who underwent partial resection, and to two published series of asymptomatic @entity362 followed without surgery. The PFS after total resection for all @entity362 is 88.1% over 20 years vs. 34.6% for partial resection at 10.5 years (p < 0.0001). The PFS for total resection of asymptomatic @entity362 rose to 98.8% vs. 60% and 67% for non-surgical treatment. Partial resection also compares poorly to non-surgical treatment for asymptomatic @entity362 . Multivariate analyses show that a low cord-sac ratio is the only independent variable that predicts good outcome. Pre-operative profiling shows the ideal @entity1 for total resection is a young @entity1 with a virgin asymptomatic @entity362 , who, with a PFS of 99.2%, is essentially cured. The technique of total resection can be learned by any neurosurgeon. Its long-term protection against symptomatic recurrence is better than partial resection and conservative management. The surgery should be done at diagnosis, except for asymptomatic small @entity1 in whom surgery should be postponed till 6 months to minimize morbidity.

Total Resection of Complex XXXX : How, Why, and When to Operate?

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient', 'infants', 'child'] @entity602 :: ('MESH:D013118', 'Disease') :: ['total resection of complex spinal cord lipomas'] @entity362 :: ('MESH:D008067', 'Disease') :: ['lipoma', 'virgin lipomas', 'lipomas']
@entity602 :: (MESH:D013118,Disease) :: ['Spinal Cord Lipomas']
