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钙化性脊膜瘤

Calcified Spinal Meningiomas.

作者信息

Ruggeri Andrea Gennaro, Fazzolari Benedetta, Colistra Davide, Cappelletti Martina, Marotta Nicola, Delfini Roberto

机构信息

Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy.

Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy.

出版信息

World Neurosurg. 2017 Jun;102:406-412. doi: 10.1016/j.wneu.2017.03.045. Epub 2017 Mar 18.

Abstract

OBJECTIVE

To analyze outcomes of patients surgically treated for calcified spinal meningiomas and to determine factors associated with surgical morbidity.

METHODS

Between January 2000 and June 2013, a total of 54 patients underwent surgical resection of a spinal meningioma: 37 of these cases showed various degrees of calcification, confirmed by histopathologic analysis. The clinical evaluation was performed according to the American Spinal Injury Association Impairment Scale. At the last follow-up, neurologic status improved in 19 cases and remained unchanged in 20 cases; just 1 case worsened. According to the American Spinal Injury Association Impairment Scale, neurologic status was classified into 3 levels: poor (A + B), fair (C), and good (D + E). Neurologic status improvement (NSI) during postoperative time (considered as a transition from one lower level to the higher) was analyzed in relationship to the patient's age, length of clinical history, spine level, meningioma's position inside the spinal canal, and its degree of calcification.

RESULTS

A statistically significant relationship between NSI and the degree of ossification of the meningioma was observed. in particular, a direct relationship with microcalcified meningiomas and an inverse relationship with ossified meningiomas. No relationship was observed between NSI and patient's age, length of clinical history, and the site of the lesion into the vertebral canal.

CONCLUSIONS

The univariate analysis confirms that the degree of calcification affects the outcome, because extensive tumor calcification is associated with an increased surgical morbidity probably.

摘要

目的

分析接受手术治疗的钙化性脊髓膜瘤患者的预后,并确定与手术并发症相关的因素。

方法

2000年1月至2013年6月期间,共有54例患者接受了脊髓膜瘤手术切除:其中37例经组织病理学分析证实有不同程度的钙化。根据美国脊髓损伤协会损伤量表进行临床评估。在最后一次随访时,19例患者神经功能状态改善,20例患者保持不变;只有1例恶化。根据美国脊髓损伤协会损伤量表,神经功能状态分为3级:差(A + B)、中(C)和好(D + E)。分析术后神经功能状态改善(NSI)(视为从较低级别向较高级别转变)与患者年龄、临床病史长度、脊柱节段、脊髓膜瘤在椎管内的位置及其钙化程度的关系。

结果

观察到NSI与脊髓膜瘤的骨化程度之间存在统计学上的显著关系。特别是,与微钙化脊髓膜瘤呈正相关,与骨化脊髓膜瘤呈负相关。未观察到NSI与患者年龄、临床病史长度以及病变在椎管内的位置之间存在相关性。

结论

单因素分析证实钙化程度影响预后,因为广泛的肿瘤钙化可能与手术并发症增加有关。

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