Department of Clinical Neurosciences-Neurosurgery, Lothian University Hospitals NHS trust, Edinburgh, UK.
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Neurosurg Rev. 2020 Aug;43(4):1047-1053. doi: 10.1007/s10143-019-01128-x. Epub 2019 Jun 18.
Outline the reported diagnostic and operative findings, and evaluate the surgical treatment outcome to clarify the best available recommendations.
Ovid Medline, Embase and PubMed central databases were searched from inception until January 2019 using the terms (subependymoma and (spinal or cervical or thoracic)). The articles were reviewed for reported spinal subependymoma cases perioperative management and treatment outcomes.
A total of 49 papers provided data on 105 cases. 47 cases were reported in the last 5 years. The reported cases were two medullary-cervical, 35 cervical, 32 cervicothoracic, 21 thoracic, 12 thoracolumbar and three lumbar. Spinal subependymomas typically arise from within the central spinal canal, giving the appearance of an intramedullary mass, usually eccentric to one side. Symptoms at presentation ranged between 1 month to 17 years, (mean 3.5 years, median 2 years) and were over 3 years in 36, and over 8 years in 12 cases. Sensory symptoms are the most frequent 75(80%), followed by weakness in 60(64%), pain in 45(48%) and sphincter disturbance in 24(25%). Postoperative neurological function was reported in 78 cases, and worsening was reported in 40 cases (51%), of which, 29 (72%) had complete resection, 6 (15%) had subtotal resection and 5 (12%) had partial resection. Neurological status remained the same in 24 (30%) and improved in 14 (18%).
The reviewed cases report a rate of 65% total resection of which 57% had worsened function after surgery. There were no reports of malignant transformation; therefore, long-term survival is expected, and surgical caution should be exercised where there is minimal symptom progression.
阐述报告的诊断和手术结果，并评估手术治疗效果，以明确最佳的治疗建议。
使用术语（室管膜下瘤和（脊髓或颈或胸）），从建库到 2019 年 1 月，在 Ovid Medline、Embase 和 PubMed central 数据库中进行检索。对报道的脊髓室管膜下瘤病例围手术期管理和治疗结果进行了回顾。
共有 49 篇论文提供了 105 例病例的数据。近 5 年有 47 例报道。报道的病例为 2 例髓颈，35 例颈，32 例颈胸，21 例胸，12 例胸腰，3 例腰。脊髓室管膜下瘤通常起源于脊髓中央管内，表现为脊髓内占位，通常向一侧偏心。发病症状从 1 个月到 17 年不等（平均 3.5 年，中位数 2 年），其中 36 例超过 3 年，12 例超过 8 年。感觉症状最为常见（75%，80%），其次是乏力（60%，64%）、疼痛（45%，48%）和括约肌功能障碍（24%，25%）。78 例报道了术后神经功能情况，40 例（51%）恶化，其中 29 例（72%）行全切除，6 例（15%）行次全切除，5 例（12%）行部分切除。24 例（30%）神经功能无变化，14 例（18%）改善。
回顾的病例中，总切除率为 65%，其中 57%的患者术后功能恶化。没有恶性转化的报道；因此，预计长期生存，手术时应谨慎，当症状进展最小化时。
