成人非脊柱裂脊髓脂肪瘤预后及影响因素分析

Prognosis and risk factors after surgical treatment of intradural spinal lipoma in adult patients without spinal dysraphism

目的探讨成人非脊柱裂脊髓脂肪瘤预后和影响因素。方法回顾性分析26例成人非脊柱裂脊髓脂肪瘤患者的临床特点、手术切除方式和随访结果。通过Log-rank分析、Kaplan-Meier分析和卡方检验,比较各预后因素对术后神经症状改善和术后复发率的影响。结果26例患者在随访中复发11例(42.31%),术后早期神经症状改善22例(88.46%),术后远期神经症状改善15例(57.69%)。经统计学分析,手术切除方式与术后复发和术后远期神经功能改善显著相关,术中是否使用3D显微镜辅助与术后复发和术后早期神经功能改善显著相关。结论3D显微镜辅助下次全切除术可以显著改善成人非脊柱裂脊髓脂肪瘤患者神经功能,有效减少术后复发。

Objective This study aimed to investigate the prognosis and risk factors after surgical treatment of intradural spinal lipoma in adult patients without spinal dysraphism.Methods The demographic characteristics,surgical intervention methods and follow-up outcome of26 patients suffering intradural spinal lipoma but without spinal dysraphism were collected and analyzed.We used Log-rank,Kaplan-Meier and Chi-Square tests to identify the factors related with the improvement of postoperative neurological symptoms and postoperative recurrence rate.Results Among the 26 patients,11 patients(42.31%)had relapsed lipomas,22 patients(88.46%)had improvement in neurological symptoms in the early postoperative period,and 15 patients(57.69%)had improvement in neurological symptoms during the long-term followup.According to the statistical analysis,the way of surgical resection is significantly related to postoperative recurrence and long-term improvement of neurological function.The use of 3 Dmicroscope during operation is significantly related to postoperative recurrence and early postoperative improvement of neurological function.Conclusion 3 D microscopy assisted subtotal resection can significantly improve the neurological function and reduce recurrence.