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儿童脊柱和脊髓肿瘤:对医疗保健系统的诊断和治疗挑战。

Spine and spinal cord tumours in children: a diagnostic and therapeutic challenge to healthcare systems.

作者信息

Wilne S, Walker D

机构信息

Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.

出版信息

Arch Dis Child Educ Pract Ed. 2010 Apr;95(2):47-54. doi: 10.1136/adc.2008.143214.

Abstract

Only 2% of childhood tumours occur in the spine and spinal cord; yet these tumours account for a disproportionate degree of morbidity in children with cancer. Spine and spinal cord tumours frequently initially present with non-specific symptoms such as back pain and clumsiness and are therefore often associated with a prolonged period between symptom onset and diagnosis. Many children present repeatedly to healthcare services before a diagnosis is made. and appropriate imaging is often only instigated once a child has developed neurological deficits. Unfortunately, despite treatment, these deficits are often only at best partially reversible. This article reviews the pathology and presentation of spine and spinal cord tumours in children and advises on the appropriate assessment of a child who may have a spine or spinal cord tumour. The principles underlying the management of these tumours are discussed and the management strategies for individual tumour types summarised.

摘要

仅有2%的儿童肿瘤发生于脊柱和脊髓;然而,这些肿瘤在患癌儿童中所导致的发病率却高得不成比例。脊柱和脊髓肿瘤最初常常表现为背痛和动作笨拙等非特异性症状,因此在症状出现到确诊之间往往会有一段很长的时间。许多儿童在确诊之前会反复就医。而且通常只有在儿童出现神经功能缺损后才会进行适当的影像学检查。不幸的是,尽管进行了治疗,但这些缺损往往最多只能部分逆转。本文回顾了儿童脊柱和脊髓肿瘤的病理学及临床表现,并就对可能患有脊柱或脊髓肿瘤的儿童进行适当评估提供建议。讨论了这些肿瘤治疗的基本原则,并总结了针对个别肿瘤类型的治疗策略。

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