Parsa Andrew T, Lee Janet, Parney Ian F, Weinstein Philip, McCormick Paul C, Ames Christopher
Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA.
J Neurooncol. 2004 Aug-Sep;69(1-3):291-318. doi: 10.1023/b:neon.0000041889.71136.62.
The management of patients with intradural spinal tumors differs in many respects from approaches taken for patients with intracranial tumors. Intramedullary lesions are often completely surrounded by normal spinal cord, displacing vital functional tracts eccentrically. Extramedullary lesions can drastically compress the spinal cord and nerve roots, reducing normal tissue to a ribbon-like consistency. The small amount of normal tissue relative to tumor has implications for surgery and postoperative adjuvant therapy. In addition, operative intervention must take spinal stability into consideration. In this report, we describe the current best care practices and strategies for patients with a diagnosis of spinal astrocytoma, ependymoma, hemangioblastoma, schwannoma, and meningioma. Treatment of patients with intradural tumors of the spinal cord and adjoining structures has changed over the past 20 years. Advances in many disciplines including neuroradiology, neurosurgery, neurooncology, and neuropathology have contributed to expediting diagnosis and improving outcomes.
硬脊膜内脊髓肿瘤患者的管理在许多方面与颅内肿瘤患者的治疗方法不同。髓内病变通常完全被正常脊髓包围，使重要的功能束偏心移位。髓外病变可严重压迫脊髓和神经根，使正常组织呈带状。相对于肿瘤而言，正常组织的量较少对手术和术后辅助治疗有影响。此外，手术干预必须考虑脊柱稳定性。在本报告中，我们描述了目前针对诊断为脊髓星形细胞瘤、室管膜瘤、血管母细胞瘤、神经鞘瘤和脑膜瘤患者的最佳护理实践和策略。在过去20年中，脊髓及毗邻结构硬脊膜内肿瘤患者的治疗发生了变化。包括神经放射学、神经外科、神经肿瘤学和神经病理学在内的许多学科的进展有助于加快诊断并改善治疗结果。
