Reimer R, Onofrio B M
J Neurosurg. 1985 Nov;63(5):669-75. doi: 10.3171/jns.1985.63.5.0669.
The authors review 32 cases of spinal cord astrocytoma in patients under 20 years of age who were treated at the Mayo Clinic between 1955 and 1980. There was a 1.3:1 male to female ratio. Twenty patients were between 6 and 15 years of age at the time of diagnosis. The duration of symptoms prior to definitive diagnosis varied from 5 days to 9 years, with an average of 24 months. The most common symptoms were pain (62.5%), gait disturbance (43.7%), numbness (18.8%), and sphincteric dysfunction (18.8%). The most common neurological findings were a Babinski response (50.0%), posterior column sensory dysfunction (40.6%), and paraparesis (37.5%). A median follow-up period of 8.6 years (range 0.8 to 25.5 years) revealed that the survival time diminished with increased histological grade of the astrocytoma (p less than 0.001). The development of postlaminectomy spinal deformities represented a serious postoperative complication. This occurred in 13 patients and was first recognized between 8 and 90 months postoperatively. Six deformities occurred following cervical laminectomy, and eight patients required at least one orthopedic procedure. It is crucial to follow these patients for an extended period of time to watch for postoperative spinal deformities.
作者回顾了1955年至1980年间在梅奥诊所接受治疗的32例20岁以下脊髓星形细胞瘤患者的病例。男女比例为1.3:1。20例患者确诊时年龄在6至15岁之间。确诊前症状持续时间从5天到9年不等，平均为24个月。最常见的症状是疼痛（62.5%）、步态障碍（43.7%）、麻木（18.8%）和括约肌功能障碍（18.8%）。最常见的神经学表现是巴宾斯基征（50.0%）、后柱感觉功能障碍（40.6%）和轻截瘫（三7.5%）。中位随访期为8.6年（范围0.8至25.5年），结果显示，随着星形细胞瘤组织学分级的增加，生存时间缩短（p<0.001）。椎板切除术后脊柱畸形的发生是一种严重的术后并发症。13例患者出现这种情况，最早在术后8至90个月被发现。6例畸形发生在颈椎椎板切除术后，8例患者至少需要进行一次矫形手术。对这些患者进行长期随访以观察术后脊柱畸形至关重要。
