Seppälä M T, Haltia M J, Sankila R J, Jääskeläinen J E, Heiskanen O
Department of Neurosurgery, Helsinki University, Finland.
J Neurosurg. 1995 Oct;83(4):621-6. doi: 10.3171/jns.1995.83.4.0621.
Are spinal schwannomas as benign as we think? To what extent do patients recover? Are patients prone to develop late complications such as cystic myelopathy or symptomatic spinal deformity? Is their life expectancy compromised? In an effort to answer these questions, the authors analyzed the long-term outcome for 187 patients from one neurosurgical department with surgically treated spinal schwannoma. Median follow-up period was 12.9 years (2454 patient years). One-fifth of the patients considered themselves free of symptoms at follow-up examination. The most common late complaint was local pain (46%), followed by radiating pain (43%), paraparesis (31%), radicular deficit (28%), sensory deficit due to a spinal cord lesion (27%), and difficulty voiding (19%). Late complications occurred in 21% of the patient population, including cystic myelopathy (2%), spinal arachnoiditis (6%), spinal deformity (6%), and troublesome pain (7%). Life expectancy of the patients corresponded to that of the general population.
脊髓神经鞘瘤真的如我们所想的那般良性吗？患者的恢复程度如何？患者出现诸如囊性脊髓病或症状性脊柱畸形等晚期并发症的倾向有多大？他们的预期寿命是否会受到影响？为了回答这些问题，作者分析了来自一个神经外科科室的187例接受手术治疗的脊髓神经鞘瘤患者的长期预后情况。中位随访期为12.9年（2454患者年）。五分之一的患者在随访检查时认为自己无症状。最常见的晚期主诉是局部疼痛（46%），其次是放射性疼痛（43%）、轻瘫（31%）、神经根功能缺损（28%）、脊髓病变导致的感觉缺损（27%）以及排尿困难（19%）。21%的患者出现了晚期并发症，包括囊性脊髓病（2%）、脊髓蛛网膜炎（6%）、脊柱畸形（6%）以及顽固性疼痛（7%）。患者的预期寿命与普通人群相当。
