Yiin Jia Jean, Chang Cheng Siu, Jan Yee Jee, Wang Yeou Chih
Department of Neurosurgery, Taichung Veterans General Hospital, ROC, Taichung, Taiwan.
J Clin Neurosci. 2003 Sep;10(5):579-83. doi: 10.1016/s0967-5868(03)00064-x.
Neuroblastoma is the most common malignant cause of spinal compression in the paediatric population. Chemotherapy is commonly considered as the first-line treatment for these patients. The role of neurosurgical decompression and radiotherapy are still controversial. Thirteen children diagnosed as having neuroblastoma with intraspinal extension were included in this report. All patients presented with neurological deficits and were treated with chemotherapy initially, after which 3 patients recovered, 4 improved and 6 were aggravated into paraplegia. Two of the 6 aggravated patients received emergent laminectomy with removal of intraspinal tumour and recovered satisfactorily. Although spread of tumour into the spinal canal indicates an advanced disease, aggressive treatments such as chemotherapy and surgical resection can often improve neurological symptoms and life quality. Neurological decompression is recommended for patients with intraspinal neuroblastoma and rapid neurological deterioration during chemotherapy.
神经母细胞瘤是小儿人群中导致脊髓压迫的最常见恶性病因。化疗通常被视为这些患者的一线治疗方法。神经外科减压和放疗的作用仍存在争议。本报告纳入了13例诊断为神经母细胞瘤伴椎管内扩展的儿童。所有患者均出现神经功能缺损，最初接受化疗，其中3例恢复，4例改善，6例加重至截瘫。6例加重患者中有2例接受了急诊椎板切除术并切除椎管内肿瘤，恢复良好。尽管肿瘤扩散至椎管表明疾病已处于晚期，但化疗和手术切除等积极治疗通常可改善神经症状和生活质量。对于患有椎管内神经母细胞瘤且在化疗期间神经功能迅速恶化的患者，建议进行神经减压。
