Lin Haiyue, Chen Xing-Yu, Gu Shixin, Liu Xiaodong, Gu Wentao, Che Xiaoming, Zhao Jianlan, Xie Rong
Department of Neurosurgery, National Center forNeurological Disorders, Neurosurgical Institute of Fudan University, Shanghai Clinical Medical Center of Neurosurgery, Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Huashan Hospital, Fudan University, Shanghai 200040, China.
Department of Neurosurgery, National Center forNeurological Disorders, Neurosurgical Institute of Fudan University, Shanghai Clinical Medical Center of Neurosurgery, Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Huashan Hospital, Fudan University, Shanghai 200040, China.
Clin Neurol Neurosurg. 2025 Feb;249:108758. doi: 10.1016/j.clineuro.2025.108758. Epub 2025 Jan 26.
Upper cervical spinal ependymomas (uCSE) is routinely identified as intramedullary ependymomas located from the oblongata medulla to C4 level. Our study aimed to report the outcomes and treatment profiles of uCSE from our cohort of uCSE patients.
This retrospective observational study included 108 patients with upper cervical spinal ependymomas (uCSE) who underwent surgery at Huashan Hospital from 2008 to 2022. Demographic and clinical data were collected to identify risk factors may associated with post-operative spinal cord function, quality of life and respiratory function.
The mean age of included patients was 44.30 ± 12.71 years old. The most common uCSE was ependymoma (103 of 108, 95.37 %), followed by subependymoma (3 of 108, 2.78 %) and anaplastic Ependymoma (2 of 108, 1.85 %). Age (P = 0.003), sex (P = 0.004), duration of symptoms (P = 0.010), pre-operative bladder functions (P = 0.012), post-operative pneumonia (P = 0.013) and Carbon Dioxide Retention (CDR) (P = 0.004) could independently correlate with Iiving quality of uCSE patients. Post-operative spinal cord function was associated with pneumonia immediately after operation (P = 0.017). In addition, post-operative pneumonia correlated with tumor location (P = 0.048), pre-operative McCormick scores (P = 0.008)/ motor functions (P = 0.022)/ NRS scores (P = 0.020), and tracheotomy immediately after operation (P < 0.001). Tracheotomy immediately after operation was associated with tumor location (P = 0.023), unsteady walking (P = 0.033), pre-operative NRS scores (P = 0.029), post-operative pneumonia (P < 0.001) and CDR (P < 0.001).
Within uCSE patients, post-operative quality of life is associated with pre-operative spinal cord function and symptom duration, which emphasizing the importance of early intervention. Their post-operative respiratory dysfunctions also correlated with post-operative spinal cord function and quality of life.
上颈段脊髓室管膜瘤（uCSE）通常被定义为位于延髓至C4水平的髓内室管膜瘤。我们的研究旨在报告我们的uCSE患者队列中uCSE的治疗结果和治疗情况。
这项回顾性观察性研究纳入了2008年至2022年在华山医院接受手术的108例上颈段脊髓室管膜瘤（uCSE）患者。收集人口统计学和临床数据，以确定可能与术后脊髓功能、生活质量和呼吸功能相关的危险因素。
纳入患者的平均年龄为44.30±12.71岁。最常见的uCSE是室管膜瘤（108例中的103例，95.37%），其次是室管膜下瘤（108例中的3例，2.78%）和间变性室管膜瘤（108例中的2例，1.85%）。年龄（P = 0.003）、性别（P = 0.004）、症状持续时间（P = 0.010）、术前膀胱功能（P = 0.012）、术后肺炎（P = 0.013）和二氧化碳潴留（CDR）（P = 0.004）可独立与uCSE患者的生活质量相关。术后脊髓功能与术后即刻肺炎相关（P = 0.017）。此外，术后肺炎与肿瘤位置（P = 0.048）、术前McCormick评分（P = 0.008）/运动功能（P = 0.022）/NRS评分（P = 0.020）以及术后即刻气管切开术相关（P < 0.001）。术后即刻气管切开术与肿瘤位置（P = 0.023）、行走不稳（P = 0.033）、术前NRS评分（P = 0.029）、术后肺炎（P < 0.001）和CDR（P < 0.001）相关。
在uCSE患者中，术后生活质量与术前脊髓功能和症状持续时间相关，这强调了早期干预的重要性。他们术后的呼吸功能障碍也与术后脊髓功能和生活质量相关。
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