分析硬脊膜外髓外肿瘤的特征和手术结果-52 例回顾性队列研究。

Analysis of characteristics and surgical outcome of intradural extramedullary tumors - a retrospective cohort study of 52 patients.

机构信息

Medical University of Plovdiv, Plovdiv, Bulgaria.

出版信息

Folia Med (Plovdiv). 2022 Aug 31;64(4):609-616. doi: 10.3897/folmed.64.e64273.

DOI:10.3897/folmed.64.e64273

PMID:36045456

Abstract

INTRODUCTION

Although intradural extramedullary tumors (IET) are relatively well studied, research on the typical epidemiological, demographic, and clinical characteristics of these malignancies is scanty.

AIM

The aim of this study was to investigate retrospectively the epidemiology, demographics, clinical presentation, imaging data, type of surgery, and the outcome of treatment of IETs.

MATERIALS AND METHODS

We performed retrospective chart review of medical history, clinical presentation, paraclinical and imaging data, and operative protocols of operated patients with IETs from January 2011 to August 2020. Special attention was paid to the onset of symptoms, clinical presentation at admission, imaging data, localization, type of surgery, histology, and outcome of the disease. The degree of neurological deficit and disability of the patients at admission, discharge, and follow-up was assessed by the Modified McCormick Scale and the Modified Rankin Scale, respectively. The follow-up period varied from 1 to 105 months (mean 43 months).

RESULTS

Fifty-two patients (mean age 58 years, range 14-78 years) with IETs were surgically treated for the study period. At admission to the clinic, 48 patients (92.3%) had vertebralgia, 34 (65.4%) had concurrent radicular pain, 42 (80.8%) had motor deficit, and 18 (34.6%) had sphincter disorders. Total tumor removal was achieved in 47 patients (90.4%). Favourable outcome was registered in 43 patients (82.7%). The degree of disability (mRS) at admission (p=0.0001), the McCormick grade at admission (p=0.0001), gender (p=0.042), and age (p=0.047) of patients were significantly correlated with the functional status assessed by McCormick scale at discharge.

CONCLUSIONS

Most of the IETs can be successfully removed via a standard posterior or posterolateral surgical access. Favourable outcome of treatment depends on early diagnosis and total tumor resection.

摘要

介绍

尽管硬脊膜外髓外肿瘤（IET）已得到广泛研究，但针对这些恶性肿瘤的典型流行病学、人口统计学和临床特征的研究却很少。

目的

本研究旨在回顾性调查 IET 的流行病学、人口统计学、临床表现、影像学数据、手术类型以及治疗结果。

材料与方法

我们对 2011 年 1 月至 2020 年 8 月期间接受手术治疗的 IET 患者的病历、临床表现、辅助检查和影像学数据及手术方案进行了回顾性分析。特别关注症状发作、入院时的临床表现、影像学数据、定位、手术类型、组织学和疾病结果。采用改良 McCormick 分级和改良 Rankin 分级分别评估患者入院、出院和随访时的神经功能缺损和残疾程度。随访时间为 1 至 105 个月（平均 43 个月）。

结果

在研究期间，52 例 IET 患者接受了手术治疗（平均年龄 58 岁，范围 14-78 岁）。就诊时，48 例（92.3%）患者有脊椎痛，34 例（65.4%）有神经根痛，42 例（80.8%）有运动障碍，18 例（34.6%）有括约肌功能障碍。47 例（90.4%）患者实现了肿瘤全切除。43 例（82.7%）患者预后良好。入院时的残疾程度（mRS）（p=0.0001）、入院时的 McCormick 分级（p=0.0001）、性别（p=0.042）和年龄（p=0.047）与出院时 McCormick 分级评估的功能状态显著相关。