Schick U, Marquardt G, Lorenz R
Clinic of Neurological Surgery, University of Leipzig, Germany.
Neurosurg Rev. 2001 Mar;24(1):20-5. doi: 10.1007/pl00011961.
The outcome of surgical treatment of benign spinal neoplasms is considered to be excellent, with good improvement of neurological function. The risk of recurrence is estimated to be very low, except with subtotal resections. This retrospective study was designed to establish the course of illness, clinical outcome, and recurrence rate of benign spinal tumours. We present an overview of the clinical outcome and surgical treatment of 197 benign spinal tumours carried out in our centre from 1980 to 1999. Clinical history, signs, surgical approach, outcome, and radiological reports were obtained by reviewing patient charts. The most frequent benign tumour was meningeoma (41%), closely followed by neurinoma (33%) and neurofibroma (6.1%). Of all tumours, 79.7% were completely resected. Recurrence happened in 10.2% on an average of 4.3 years postoperatively. Only 2 patients suffered from neurofibromatosis. All neurinomas were completely resected at first operation, whereas three out of seven recurrent meningeomas and all ependymomas were classified as subtotally resected. Seventy per cent were treated by repeated surgical intervention. Benign tumours usually can be completely removed without adding to patients' neurological deficits. Benign tumours recur in 10.2% of cases, thus requiring long-term follow-up. Magnetic resonance imaging (MRI) studies are recommended up to 5 years postoperatively as a routine procedure.
良性脊柱肿瘤的手术治疗效果被认为极佳,神经功能有良好改善。除次全切除外,复发风险估计非常低。这项回顾性研究旨在确定良性脊柱肿瘤的病程、临床结果和复发率。我们概述了1980年至1999年在我们中心进行的197例良性脊柱肿瘤的临床结果和手术治疗情况。通过查阅患者病历获取临床病史、体征、手术方式、结果及影像学报告。最常见的良性肿瘤是脑膜瘤(41%),其次是神经鞘瘤(33%)和神经纤维瘤(6.1%)。所有肿瘤中,79.7%被完全切除。复发率为10.2%,平均在术后4.3年出现。仅2例患者患有神经纤维瘤病。所有神经鞘瘤在首次手术时均被完全切除,而7例复发性脑膜瘤中的3例以及所有室管膜瘤被归类为次全切除。70%的患者接受了再次手术干预。良性肿瘤通常可以完全切除而不增加患者神经功能缺损。良性肿瘤在10.2%的病例中复发,因此需要长期随访。建议术后5年内常规进行磁共振成像(MRI)检查。