Phankhongsab Anuchit, Sopchokchai Intouch, Piromchai Patorn
Department of Surgery, Neurosurgery Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Research Affairs, Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Craniovertebr Junction Spine. 2024 Jul-Sep;15(3):361-366. doi: 10.4103/jcvjs.jcvjs_53_24. Epub 2024 Sep 12.
Intradural extramedullary (IDEM) tumors are rare tumors of the spinal cord. Currently, there is no evidence on the factors that predict poor outcomes in the patients. The objective of this study was to determine the prognostic factors that are associated with poor outcomes in IDEM tumors.
Patients 18 years and older with IDEM tumors who underwent surgery at our institute were identified and retrospectively reviewed. The patient's demographic data, risk factors, and modified McCormick Scale score were collected.
A total of 129 patients with IDEM were included in this study. The age ranged from 19 to 79 years (mean 51.3 years), with a predominantly female population (85 patients, 65.9%). Eighty-nine (68.9%) patients had a good outcome, while 40 (31.0%) patients had a poor outcome. The significant factors for poor outcomes included the number of vertebral levels removed for tumor access (adjusted odds ratio [OR] = 3.80, 95% confidence interval [CI] =1.30-11.08, = 0.013); pathology other than meningioma, schwannoma, and neurofibroma (adjusted OR = 18.86, 95% CI = 2.16-164.49, = 0.007); and bowel/bladder involvement (adjusted OR = 3.47, 95% CI = 1.15-10.39, = 0.027).
We found that the factors for poor outcomes included bowel/bladder involvement, number of vertebral levels removed for tumor access, and pathology other than meningioma, schwannoma, and neurofibroma.
硬脊膜内髓外(IDEM)肿瘤是脊髓的罕见肿瘤。目前,尚无证据表明哪些因素可预测患者的不良预后。本研究的目的是确定与IDEM肿瘤不良预后相关的预后因素。
确定在我们研究所接受手术的18岁及以上的IDEM肿瘤患者,并进行回顾性分析。收集患者的人口统计学数据、危险因素和改良的麦考密克量表评分。
本研究共纳入129例IDEM患者。年龄范围为19至79岁(平均51.3岁),以女性为主(85例,65.9%)。89例(68.9%)患者预后良好,40例(31.0%)患者预后不良。不良预后的显著因素包括为切除肿瘤而切除的椎体节段数量(调整后的优势比[OR]=3.80,95%置信区间[CI]=1.30-11.08,P=0.013);除脑膜瘤、神经鞘瘤和神经纤维瘤以外的病理类型(调整后的OR=18.86,95%CI=2.16-164.49,P=0.007);以及肠道/膀胱受累(调整后的OR=3.47,95%CI=1.15-10.39,P=0.027)。
我们发现不良预后的因素包括肠道/膀胱受累、为切除肿瘤而切除的椎体节段数量,以及除脑膜瘤、神经鞘瘤和神经纤维瘤以外的病理类型。