Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota; First Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
World Neurosurg. 2019 Aug;128:587-592.e2. doi: 10.1016/j.wneu.2019.04.110. Epub 2019 Apr 19.
Lipomatosis of nerve (LN) is one part of the spectrum of adipose lesions of nerve. Nerve-territory overgrowth is present in approximately 62% of cases. Given the wide variability in published reports, there is substantial need to understand the results of surgical treatment and outcomes in this disorder.
Raw data from the published systematic review of LN were used for this analysis. PubMed and Google Scholar databases were also screened for any additional papers. The cases were sorted into 2 groups: (1) definite LN cases and (2) probable LN cases (lacked definite proof of LN diagnosis). For statistical analysis, P-value <0.05 was considered statistically significant.
The total number of 486 definite and 160 probable LN cases (646 cases combined) was included for analysis. The most commonly performed procedure was nerve decompression in both definite (n = 104; 21.4%) and combined definite and probable LN groups (n = 107; 16.6%). Improvement of symptoms was most often reported after nerve decompression (n = 52). A soft-tissue debulking procedure had the highest association with improvement (odds ratio 144.6, 95% confidence interval: 13.8-1516.2, P <0.001) in the definite LN group.
Treatment options for LN ranges widely, although notable consistencies exist. The most conservative procedure involving nerve decompression was the most commonly performed procedure, with reported good outcomes. In contrast, worsening of symptoms was most commonly reported when nerve resection was performed. All treatment modalities were associated with improvement compared with no treatment. Diagnostic biopsy should be avoided.
神经脂肪瘤病（LN）是神经脂肪病变谱的一部分。约有 62%的病例存在神经区域过度生长。鉴于已发表报告中的差异很大，因此非常有必要了解该疾病的手术治疗结果和预后。
使用已发表的 LN 系统评价的原始数据进行了这项分析。还对 PubMed 和 Google Scholar 数据库进行了筛选，以查找任何其他论文。将病例分为 2 组：（1）明确的 LN 病例和（2）可能的 LN 病例（缺乏明确的 LN 诊断证据）。进行统计分析时，P 值<0.05 被认为具有统计学意义。
共纳入了 486 例明确和 160 例可能的 LN 病例（总计 646 例）进行分析。在明确的 LN 病例（n=104；21.4%）和明确和可能的 LN 联合组（n=107；16.6%）中，最常进行的手术是神经减压术。在神经减压术后，症状改善最为常见（n=52）。在明确的 LN 组中，软组织切除术与改善的相关性最高（优势比 144.6，95%置信区间：13.8-1516.2，P<0.001）。
LN 的治疗选择范围很广，尽管存在显著的一致性。涉及神经减压术的最保守手术是最常进行的手术，报告的结果良好。相比之下，当进行神经切除术时，症状恶化最为常见。与不治疗相比，所有治疗方式都与改善相关。应避免诊断性活检。
