Prevedello Daniel Monte-Serrat, Koerbel Andrei, Tatsui Claudio Esteves, Truite Luciano, Grande César Vinícius, Ditzel Léo Fernando da Silva, Araújo João Cândido
Departamento de Neurocirurgia, Hospital Nossa Senhora das Graças, Brasil.
Arq Neuropsiquiatr. 2003 Jun;61(2A):241-7. doi: 10.1590/s0004-282x2003000200014. Epub 2003 Jun 9.
Between 1993 and 1999, 44 patients submitted to resection of an expansible intradural extramedullary lesion who filled protocol requirements of appropriate follow up were studied. Patients were constituted by 43.2% female and 56.8% male. The mean age was 32.9 years old. Lesion most common location was at the thoracic spine, with 45.5% of the cases, followed by the lumbar level with 18.2%. Tumor extension varied from 1 to 7 vertebral segments, with an average of 2.5 levels. Schwannoma, with 65,9% of the cases, was the most frequent lesion, followed by meningioma with 20.5%. There were 2 cases of neurofibroma and 1 case of paraganglioma, neuroenteric cyst, metastasis and malignant schwannoma. The evolution was of improvement in 56.8%, stability in 31.8% and of worsening in 11.4%. There was no mortality related to the surgical procedure. All cases of worsening had total resection and they had lesions located in the thoracic segment. Total resection is the ideal modality of surgical treatment. However, at the thoracic level, where the peculiarities of spine irrigation prevail, surgical morbidade may be higher (p=0.014).
1993年至1999年间,对44例接受可扩张性硬脊膜内髓外病变切除术且符合适当随访方案要求的患者进行了研究。患者中女性占43.2%,男性占56.8%。平均年龄为32.9岁。病变最常见的部位是胸椎,占45.5%的病例,其次是腰椎,占18.2%。肿瘤累及范围为1至7个椎体节段,平均为2.5个节段。神经鞘瘤最为常见,占65.9%的病例,其次是脑膜瘤,占20.5%。有2例神经纤维瘤、1例副神经节瘤、神经肠囊肿、转移瘤和恶性神经鞘瘤。病情转归为改善的占56.8%,稳定的占31.8%,恶化的占11.4%。没有与手术相关的死亡病例。所有病情恶化的病例均接受了全切除,且病变位于胸段。全切除是理想的手术治疗方式。然而,在胸椎水平,由于脊柱灌注的特殊性,手术 morbidity可能更高(p=0.014)。 (注:原文中“morbidade”可能有误,推测应为“morbidity”,即发病率、并发症等意思,这里暂按此理解翻译)