Hsu Wesley, Pradilla Gustavo, Constantini Shlomi, Jallo George I
Department of Neurosurgery, The Johns Hopkins University School of Medicine, Meyer Bldg. 8-161, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Childs Nerv Syst. 2009 Oct;25(10):1253-9. doi: 10.1007/s00381-009-0882-y. Epub 2009 Apr 10.
The objective of this manuscript is to discuss current management strategies regarding pediatric patients with intramedullary spinal cord ependymomas. Spinal ependymoma is the second most common spinal cord tumor in children. The clinical evaluation of these patients, operative techniques, postoperative management considerations, and long-term outcomes are discussed.
The gold standard for the treatment of spinal ependymoma continues to be gross total resection. Patients with residual tumor postoperatively may benefit from adjuvant radiation therapy. Intraoperative monitoring is critical to minimize permanent postoperative neurologic deficit.
Patients requiring multilevel laminectomy may benefit from concomitant laminoplasty or instrumented fusion to avoid progressive spinal column deformity.
本手稿的目的是讨论目前针对小儿脊髓室管膜瘤患者的管理策略。脊髓室管膜瘤是儿童第二常见的脊髓肿瘤。本文讨论了这些患者的临床评估、手术技术、术后管理注意事项及长期预后。
脊髓室管膜瘤治疗的金标准仍然是全切除。术后有残留肿瘤的患者可能从辅助放疗中获益。术中监测对于将术后永久性神经功能缺损降至最低至关重要。
需要进行多级椎板切除术的患者可能受益于同期椎板成形术或器械融合术,以避免脊柱畸形进展。