脊髓室管膜下瘤诊断和显微外科治疗

Diagnosis and microsurgical treatment of spinal cord subependymoma

目的总结脊髓室管膜下瘤的临床特点和治疗方法。方法回顾性分析9例脊髓室管膜下瘤的临床资料,均采用显微外科手术治疗,结合术中所见对诊断和治疗进行分析。结果肿瘤全切除3例,近全切除4例,大部分切除2例。病理检查显示：室管膜下瘤8例,室管膜下瘤含室管膜瘤成分1例。术后肢体肌力不同程度好转7例,减退2例;括约肌障碍恢复正常1例;短期浅、深感觉障碍均较术前略加重;无手术死亡病例。随访12~36个月,非全切病人中肿瘤复发3例。结论脊髓室管膜下瘤少见,手术可缓解病人临床症状,显微镜下全切除是最佳治疗选择。

Objective To summarize the clinical characteristics and treatment of spinal cord subependymoma.Methods Clinical data of 9 patients with spinal cord subependymoma were analyzed retrospectively.Microsurgery was performed in all the cases,and the diagnosis and treatment were analyzed along with operative findings.Results Total removal was performed in 3 patients,subtotal in 4 and partial in 2.The lesions were diagnosed by pathological examination,including subependymoma in 8 cases and subependymoma containing ependymoma in 1.Postoperatively muscle force was improved in 7 patients and weakened in 2.Sphincter disturbance disappeared in 1 case.Deep and superficial sensation disturbances aggravated in the short term in all the patients.No patients died.A follow-up was performed from 12 to 36 months,tumor recurrence occurred in 3 cases.Conclusions Spinal cord subependymoma is rare,and surgery can release clinical symptoms.Total resection via microsurgery is the best choice forspinal cord subependymoma.