Quality of Life Outcomes Following Surgical Resection of Intramedullary Spinal Cord Tumors: A Retrospective Study Using the EuroQol Five-Dimension Five-Level Instrument

Abstract

Introduction

Conventional outcome reporting emphasizes neurological examination and extent of resection, but these metrics do not fully capture recovery from the patient’s perspective. The study aims to evaluate postoperative change in health-related quality of life among patient who had undergone surgical resection of intramedullary spinal cord tumor using the EuroQol 5-Dimensions 5-Levels instrument and the EuroQol Visual Analog Scale.

Methods

This retrospective study included 34 patients who underwent surgery between February 2022 and March 2025. Preoperative and postoperative EuroQol 5-Dimensions 5-Levels utility scores and EuroQol Visual Analog Scale scores were analyzed. Utility values were derived using the Indian EuroQol 5-Dimensions 5-Levels tariff. Standardized response means were calculated, and clinically meaningful improvement was defined as a utility increase of at least 0.05 and a EuroQol Visual Analog Scale increase of at least 7 points.

Results

Mean utility increased from 0.397 ± 0.489 to 0.456 ± 0.530, for a mean change of 0.059 (95% confidence interval: -0.029 to 0.147; p = 0.182). Mean EuroQol Visual Analog Scale improved from 42.8 ± 19.7 to 53.1 ± 29.7, for a mean change of 10.29 points (95% confidence interval: 2.55 to 18.03; p = 0.011). Eighteen patients (52.9%) met the utility responder threshold, 21 (61.8%) met the EuroQol Visual Analog Scale responder threshold, and 15 (44.1%) met both. Gross total resection was achieved in 22 patients (64.7%).

Conclusion

Surgery for primary intramedullary spinal cord tumors was associated with meaningful improvement in patient-rated overall health, even though cohort-level change in utility was modest. Patient-reported outcome measures add clinically relevant information beyond conventional neurological and radiographic end points.