Department of Neurosurgery, Neurosciences Center, Room No. 712, Ansari Nagar, All India Institute of Medical Sciences, New Delhi 110029, India.
J Clin Neurosci. 2013 Feb;20(2):292-8. doi: 10.1016/j.jocn.2012.01.056. Epub 2012 Dec 28.
We retrospectively reviewed the outcomes of 195 patients with intramedullary tumors who underwent surgery between January 2001 and December 2010 at a single institution. The symptomatology, neurological and neuroradiological findings, operative details, perioperative and postoperative complications, histopathological data and follow-up examinations of the 137 (70.2%) males and 58 (29.7%) females were studied and analyzed. Epidermoid was the most common intramedullary tumour in children (23%), whereas in adults, ependymomas were more common (46%). Ependymomas were more amenable to resection (total excision in 57.7% and near-total excision in 39.4%) as compared to astrocytomas (total excision in 29%; near total excision in 60.5%). At the final clinical follow-up, 24 patients (16.4%) had improved in McCormick grade, 112 patients (76.7%) remained unchanged and 11 patients (7.5%) had worsened. Complete removal of the lesion is the primary goal of surgery. We conclude that the strongest predictor of functional outcome was the preoperative neurological condition, beyond the histological differentiation of the intramedullary tumor.
我们回顾性分析了 195 例于 2001 年 1 月至 2010 年 12 月在单家机构接受手术治疗的髓内肿瘤患者的结局。研究并分析了 137 例男性（70.2%）和 58 例女性（29.7%）患者的症状、神经学和神经影像学发现、手术细节、围手术期和术后并发症、组织病理学数据以及随访检查。表皮样囊肿是儿童中最常见的髓内肿瘤（23%），而在成人中，室管膜瘤更为常见（46%）。与星形细胞瘤相比（完全切除率为 29%，近全切除率为 60.5%），室管膜瘤更易于切除（完全切除率为 57.7%，近全切除率为 39.4%）。在最终的临床随访中，24 例患者（16.4%）的 McCormick 分级改善，112 例患者（76.7%）无变化，11 例患者（7.5%）恶化。完全切除病变是手术的主要目标。我们的结论是，功能结局的最强预测因素是术前神经状况，而不是髓内肿瘤的组织学分化。
