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巴西一家机构对手术治疗的原发性脊髓肿瘤的评估:104例患者的病例系列研究

Evaluation of Surgically Treated Primary Spinal Cord Tumors in a Single Brazilian Institution: A Case Series Study of 104 Patients.

作者信息

Santos Júnior Eustáquio C, Dantas François, Caires Antônio Carlos V, Cariri Gustavo A, Reis Marco Túlio D, Botelho Ricardo V, Dantas Fernando Luiz R

机构信息

Neurological Surgery, Biocor Instituto, Belo Horizonte, BRA.

Neurological Surgery, Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), São Paulo, BRA.

出版信息

Cureus. 2022 Mar 22;14(3):e23408. doi: 10.7759/cureus.23408. eCollection 2022 Mar.

Abstract

BACKGROUND

Primary spinal cord tumors are rare and heterogeneous, and their prevalence varies among the studies. Few articles have evaluated the prevalence, characteristics, and histological types of spinal cord tumors in Latin American populations. This study aimed to analyze the histological types and clinical aspects of a series of consecutive patients diagnosed with primary spinal cord tumors who underwent surgical treatment in a single Brazilian institution and to compare them with the literature.

METHODS

This is a case series study, with retrospective analysis of all consecutive adult patients who underwent surgical treatment for primary spinal cord tumors in a single center between January 1997 and April 2021. Data analyzed included age at surgery, sex, anatomical location, histopathological diagnosis, clinical presentation, and neurological status at discharge.

RESULTS

A total of 104 patients (53 women [51.0%]; mean age, 49.0 ± 16.7 years [range, 19-87 years]) were included in the analysis. Among the tumors, 83.7% were benign, and 36.5% involved the thoracic spine; intradural extramedullary lesions comprised 52.9% of the tumors, and the most prevalent were schwannomas (26.9%) and meningiomas (18.3%). Among the patients, 55% and 50% presented with pain and motor deficit, respectively, and the deficit improvement rate was greater than the worsening rate at the immediate postoperative period and discharge.

CONCLUSIONS

Our series highlights the heterogeneity of primary spinal cord tumors compared to other studies. Further large population studies are necessary to elucidate the epidemiology of this disease.

摘要

背景

原发性脊髓肿瘤罕见且具有异质性,不同研究中其患病率有所不同。很少有文章评估拉丁美洲人群脊髓肿瘤的患病率、特征和组织学类型。本研究旨在分析一系列在巴西一家机构接受手术治疗的连续诊断为原发性脊髓肿瘤患者的组织学类型和临床情况,并与文献进行比较。

方法

这是一项病例系列研究,对1997年1月至2021年4月期间在单一中心接受原发性脊髓肿瘤手术治疗的所有连续成年患者进行回顾性分析。分析的数据包括手术年龄、性别、解剖位置、组织病理学诊断、临床表现和出院时的神经状态。

结果

共有104例患者(53例女性[51.0%];平均年龄49.0±16.7岁[范围19 - 87岁])纳入分析。在这些肿瘤中,83.7%为良性,36.5%累及胸椎;硬膜内髓外病变占肿瘤的52.9%,最常见的是神经鞘瘤(26.9%)和脑膜瘤(18.3%)。在患者中,分别有55%和50%出现疼痛和运动功能障碍,术后即刻和出院时功能障碍改善率大于恶化率。

结论

与其他研究相比,我们的系列研究突出了原发性脊髓肿瘤的异质性。需要进一步开展大规模人群研究以阐明该疾病的流行病学情况。

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本文引用的文献

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An overview of the tumors affecting the spine-inside to out.从内到外影响脊柱的肿瘤概述。
Neurooncol Pract. 2020 Nov 18;7(Suppl 1):i10-i17. doi: 10.1093/nop/npaa049. eCollection 2020 Nov.
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Intradural spinal tumors: 10 - years surgical experience in a single institution.硬脊膜内脊髓肿瘤:单一机构的10年手术经验
Clin Neurol Neurosurg. 2018 Jun;169:98-102. doi: 10.1016/j.clineuro.2018.03.013. Epub 2018 Mar 10.

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