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髓内硬膜外肿瘤术后神经并发症:单中心10年经验

Postoperative neurological complications in intradural extramedullary tumors: A 10-year experience of a single center.

作者信息

Arima Hideyuki, Hasegawa Tomohiko, Yamato Yu, Yoshida Go, Banno Tomohiro, Oe Shin, Mihara Yuki, Ide Koichiro, Watanabe Yuh, Nakai Keiichi, Kurosu Kenta, Matsuyama Yukihiro

机构信息

Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, 431-3192 Hamamatsu-city, Shizuoka, Japan.

Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, 431-3192 Hamamatsu-city, Shizuoka, Japan.

出版信息

Neurochirurgie. 2023 Sep;69(5):101476. doi: 10.1016/j.neuchi.2023.101476. Epub 2023 Aug 4.

Abstract

BACKGROUND

Intradural extramedullary spinal cord tumors (IDEMs) cause neurological symptoms due to compression of the spinal cord and caudal nerves. The purpose of this study was to investigate the incidence of postoperative neurological complications after surgical resection of IDEM and to identify factors associated with such postoperative neurological complications.

METHODS

We retrospectively analyzed 85 patients who underwent tumor resection for IDEM between 2010 and 2020. We investigated the postoperative worsening of neurological disorders. The patients were divided into two groups: those with and without postoperative neurological complications. Patient demographic characteristics, tumor level, histological type, and surgery-related factors were also compared.

RESULTS

The mean age at the time of surgery was 57.4 years, and histological analysis revealed 45 cases of schwannoma, 34 cases of meningioma, three cases of myxopapillary ependymoma, one case of ependymoma, one case of hemangioblastoma and one case of lipoma. There were five cases (5.8%) of postoperative neurological complications, and four patients improved within 6 months after surgery, and one patient had residual worsening. There were no statistically significant differences in age, sex, tumor location, preoperative modified McCormick Scale grade, histology, tumor occupancy, or whether fixation was performed in the presence or absence of postoperative neurological complications. All four cases of meningioma with postoperative neurological complications had preoperative neuropathy and meningiomas were located in the anterior or lateral thoracic spine.

CONCLUSIONS

Neurological complications after surgical resection for IDEM occurred in 5.8% of patients. Meningiomas with postoperative neurological complications located anteriorly or laterally in the thoracic spine.

摘要

背景

硬脊膜内髓外脊髓肿瘤(IDEMs)由于压迫脊髓和尾神经而导致神经症状。本研究的目的是调查IDEMs手术切除术后神经并发症的发生率,并确定与术后神经并发症相关的因素。

方法

我们回顾性分析了2010年至2020年间接受IDEMs肿瘤切除术的85例患者。我们调查了神经功能障碍的术后恶化情况。患者被分为两组:有和没有术后神经并发症的患者。还比较了患者的人口统计学特征、肿瘤水平、组织学类型和手术相关因素。

结果

手术时的平均年龄为57.4岁,组织学分析显示45例神经鞘瘤、34例脑膜瘤、3例黏液乳头状室管膜瘤、1例室管膜瘤、1例血管母细胞瘤和1例脂肪瘤。有5例(5.8%)术后出现神经并发症,4例患者在术后6个月内好转,1例患者仍有残留恶化。术后神经并发症的有无在年龄、性别、肿瘤位置、术前改良麦考密克量表分级、组织学、肿瘤占位或是否进行固定方面无统计学显著差异。所有4例术后出现神经并发症的脑膜瘤患者术前均有神经病变,且脑膜瘤位于胸椎前方或外侧。

结论

IDEMs手术切除术后神经并发症的发生率为5.8%。术后出现神经并发症的脑膜瘤位于胸椎前方或外侧。

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