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影响小儿脊髓肿瘤诊断延迟的患者因素。

Patient factors influencing a delay in diagnosis in pediatric spinal cord tumors.

机构信息

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Nagoya J Med Sci. 2022 Aug;84(3):516-525. doi: 10.18999/nagjms.84.3.516.

Abstract

The diagnosis of pediatric spinal cord tumor is frequently delayed due to the presence of non-specific symptoms. We investigated the factors influencing the delay between the first symptom presentation and the diagnosis for pediatric spinal cord tumor. We retrospectively analyzed 31 patients of age <20 years (18 men, 13 women) who underwent surgery for spinal cord tumor at a single center during 1998-2018. We extracted the relevant data on patients' symptoms, affected spinal location (cervical: C1-7, thoracic: T1-T12, and lumbosacral: L1-S), and tumor anatomical location (extradural, intradural extramedullary, and intramedullary tumor) that could potentially affect the duration of symptom presentation prior to the diagnosis. The most common symptom presented in the patients was pain (n = 22, 71.0 %). Motor symptoms such as paralysis was associated with early diagnosis (P = 0.039). The duration of symptoms prior to diagnosis was found to be significantly longer in patients with spinal tumor in the lumbar-sacral region than in those with the involvement of the cervical and thoracic regions (2.1 ± 1.7 months vs 13.6 ± 12.1 months; P = 0.006 and 2.9 ± 2.2 months vs 13.6 ± 12.1 months; P = 0.012, respectively). Our study results demonstrated that pain was the most common symptom in the examined patients, although it did not affect the delay in diagnosis, whereas the presentation of motor symptoms was helpful in the diagnosis of pediatric spinal cord tumor and the diagnosis could be delayed in lumbar-sacral spinal tumors.

摘要

小儿脊髓肿瘤的诊断常因症状不典型而延误。我们研究了影响小儿脊髓肿瘤首发症状至确诊时间间隔的因素。回顾性分析了 1998 年至 2018 年在单一中心接受手术治疗的 31 例年龄<20 岁(男 18 例,女 13 例)脊髓肿瘤患者。我们提取了与患者症状、受累脊髓部位(颈段:C1-7;胸段:T1-T12;腰骶段:L1-S)和肿瘤解剖部位(硬膜外、硬脊膜外髓内和髓内肿瘤)相关的资料,这些资料可能影响症状出现至确诊的时间。患者最常见的首发症状是疼痛(n = 22,71.0%)。运动症状如瘫痪与早期诊断相关(P = 0.039)。腰骶段脊髓肿瘤患者的症状持续时间明显长于颈胸段脊髓肿瘤患者(2.1±1.7 个月 vs 13.6±12.1 个月;P = 0.006 和 2.9±2.2 个月 vs 13.6±12.1 个月;P = 0.012)。我们的研究结果表明,疼痛是检查患者中最常见的症状,但它并不影响诊断的延迟,而运动症状的出现有助于小儿脊髓肿瘤的诊断,且腰骶段脊髓肿瘤的诊断可能会被延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba06/9529625/a1a9973ec02f/2186-3326-84-0516-g001.jpg

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