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[儿童和青少年脊柱肿瘤手术治疗的长期结果]

[Long-Term Results of Surgical Treatment of Spinal Tumours in Children and Adolescents].

作者信息

Grote W, Römer F, Bock W J, Bockhorn J, Bushe K A, Entzian W, Szepan B

出版信息

Monatsschr Kinderheilkd (1902). 1975 Mar;123(3):112-9.

PMID:1128519
Abstract

Catamneses of children up to the age of 16, operated on spinal tumours, are reported. Spinal tumours of this age account for about 15% of the total (all ages). There are about 50% intradural and 50% extradural tumours. The most frequent extradural tumours are sarcomas, followed by lipomas and dysontogenetic tumours like teratomas. Intradural tumours consist of intramedullary and extramedullary ones, about 50% each. Intramedullary tumours are gliomas, extramedullary ones may be neurinomas, meningeomas and vascular tumours. Time from onset of first diffuse symptoms up to clinical diagnosis depends on growth tendency of the tumour as well as on its localization. Hence, case history in cases of intramedullary gliomas usually covers two years, of sarcomas only a couple of months. In half of the cases, pain was the first symptom, followed by disturbed motor function. In more than 50% of the cases, complete restoration or significant improvement could be achieved by surgery. In the remaining half, there was either no change or even deterioration of the disturbed function. It seems justified to replace the former pessimistic attitude towards therapy of spinal tumours in childhood by a discret optimism. If in addition other spinal diseases like disk herniation are taken into account, prognosis is even more favourable.

摘要

报告了16岁以下接受脊髓肿瘤手术儿童的随访情况。这个年龄段的脊髓肿瘤约占总数(所有年龄段)的15%。硬膜内肿瘤和硬膜外肿瘤各占约50%。最常见的硬膜外肿瘤是肉瘤,其次是脂肪瘤和发育异常性肿瘤如畸胎瘤。硬膜内肿瘤包括髓内肿瘤和髓外肿瘤,各占约50%。髓内肿瘤是胶质瘤,髓外肿瘤可能是神经鞘瘤、脑膜瘤和血管肿瘤。从首次出现弥漫性症状到临床诊断的时间取决于肿瘤的生长趋势及其位置。因此,髓内胶质瘤病例的病史通常长达两年,而肉瘤病例仅几个月。半数病例中,疼痛是首发症状,其次是运动功能障碍。超过50%的病例通过手术可实现完全恢复或显著改善。其余半数病例中,功能障碍要么没有变化,甚至出现恶化。用适度的乐观态度取代过去对儿童脊髓肿瘤治疗的悲观态度似乎是合理的。如果再考虑其他脊柱疾病如椎间盘突出,预后会更有利。

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