Department of Neurosurgery, Health Science University, Bakirköy Research and Training Hospital for Neurology Neurosurgery and Psychiatry, Istanbul, Turkey.
Department of Neurosurgery, Bezmialem Vakif University, Istanbul, Turkey.
Med Sci Monit. 2018 Oct 5;24:7072-7089. doi: 10.12659/MSM.910447.
BACKGROUND The aim of this study was to assess the clinical and radiological outcomes of surgical treatment for primary spinal ependymoma in children. MATERIAL AND METHODS Medical records of 46 primary spinal ependymoma patients who underwent surgery in BRSHH hospital during a 12-year period from 2004 to 2015 were retrospectively reviewed. All pediatric patients (patient age <18 years) were selected as the core sample used for this study. RESULTS This series included 1 female and 2 male patients between the ages of 9 and 17 years with mean age 13.3±3.9 years. The mean preoperative course was 9.1±10.5 months. The most common location was the lumbar spinal cord (n=2). The most common presenting symptoms was lower-limb weakness and numbness. Two tumors were located intradural-intramedullary and 1 was located intradural-extramedullary. Gross-total resection (GTR) was achieved in 2 patients, and a near-total resection was performed in 1 patient. No adjuvant treatment was received. The mean follow-up duration was 51.3±37.6 (17-98) months. No complications were recorded. Functional assessment of all patients by the latest follow-up evaluation showed good progress even though the patient is not fully recovered. At 6.3 years after the first operation, 1 patient presented with drop-seeding metastasis. No patients had neurofibromatosis type 2. CONCLUSIONS Laminoplasty and intraoperative neurophysiological monitorization are essential in surgical treatment of pediatric spinal ependymomas. GTR and recovery in pediatric spinal ependymoma are more likely than in adults. Despite the GTR, the risk of drop metastasis remains. Therefore, close clinical and radiological follow-up is recommended.
本研究旨在评估儿童原发性脊髓室管膜瘤手术治疗的临床和影像学结果。
回顾性分析了 2004 年至 2015 年期间在 BRSHH 医院接受手术治疗的 46 例原发性脊髓室管膜瘤患者的病历。所有儿科患者（患者年龄<18 岁）均被选为该研究的核心样本。
本系列包括 1 名 9 至 17 岁的女性和 2 名男性患者，平均年龄为 13.3±3.9 岁。平均术前病程为 9.1±10.5 个月。最常见的部位是腰椎脊髓（n=2）。最常见的表现症状是下肢无力和麻木。2 个肿瘤位于硬脊膜内-脊髓内，1 个位于硬脊膜外-脊髓外。2 例患者行全切除（GTR），1 例患者行近全切除。未接受辅助治疗。平均随访时间为 51.3±37.6（17-98）个月。无并发症记录。所有患者在最新随访评估中的功能评估均显示出良好的进展，尽管患者尚未完全康复。首次手术后 6.3 年，1 例患者出现播散性转移。无患者患有神经纤维瘤病 2 型。
对于儿童脊髓室管膜瘤的手术治疗，椎板成形术和术中神经生理监测是必不可少的。儿童脊髓室管膜瘤的 GTR 和恢复可能性大于成人。尽管行 GTR，但仍存在播散转移的风险。因此，建议密切进行临床和影像学随访。
