|Table of Contents|

Analysis of the clinical diagnosis and surgical treatment of intraspinal tumors

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2016 06
Page:
964-967
Research Field:
Publishing date:

Info

Title:
Analysis of the clinical diagnosis and surgical treatment of intraspinal tumors
Author(s):
Wang Jin; Yang Tongtao; Qian Jixian; Sun Honghui; Li Cunxiao; Yu Zhe; Hua Mingyu; Gao Tongshuan; Fan Qingyu; Zhang Minghua; Zhou Yong
Orthopedic Oncology Institute of PLA，Tangdu Hospital，Fourth Military Medical University，Shaanxi Xi＇an 710038,China．
Keywords:
intraspinal tumors; diagnosis; operation
PACS:
R739.42
DOI:
10.3969/j.issn.1672-4992.2016.06.035
Abstract:
Objective:To summarize the diagnostic key of the intraspinal tumors and evaluate the effect of surgery.Methods:A retrospective analysis of 164 patients with intraspinal tumors treated with surgery from 2006 to 2014 was conducted to summarize the diagnostic key and evaluate the effect of surgery.Results:The clinical symptoms of intraspinal tumors varied,the main manifestations were pain,sensory and movement disorders.The symptoms were closely related to the segment,location and size of the tumors.The accuracy rate of MRI to tumor localization was 100%,and 122 cases of MRI were in accordance with the pathological diagnosis,accounting for 74.4%.There were 8 cases of tumor recurrence.At last follow-up,ASIA grade was improved significantly (Z=-12.617,P=0.000) compared with preoperative grade except 10 patients without change and 4 cases of patients were increasing.There were 57 cases of spinal pedicle screw internal fixation (11 cases of cervical vertebra,3 cases of thoracic vertebra,43 cases of lumbar vertebra) and 164 cases of spinal stability after operation were performed.The complications included 4 cases of cerebrospinal fluid leakage,and 2 cases of postoperative hematoma,which was cured by treatment.Conclusion:Although the clinical manifestations of intraspinal tumors are complex and varied,MRI has the significance of tumor location,qualitative analysis,spinal nerve compression,ischemic state,and guidingthe surgery.The exposure range of posterior approach surgery and spinal stability reconstruction should be determined by the tumor segment,the extent of the loss of the structure of the segment,and the functional requirements.Surgery and neurological function risk estimates should be good communication with patients.

References:

［1］Xiu BH,Liu SM,Shi YC,et al.Diagnosis and microsurgical treatment of intraspinal tumors［J］.Chin J Neurosurg Dis Res,2011,10(4):341-344.［修彬华，刘绍明，史有才，等.椎管内肿瘤的诊断与显微外科治疗［J］.中华神经外科疾病研究杂志，2011,10(4):341-344.］
［2］Denis F.The three column spine and its significance in the classification of acute thoracolumbar spinal injuries［J］.Spine (Phila Pa 1976),1983,8(8):817-831.
［3］Kostuik JP,Errico JN.Differential diagnosis and surgical treatment of metastastic spine tumors［A］.Frymoyer JW.The adult spine:Principles and practice［M］.New York:Raven,1991:861-888.
［4］Izzo R,Guarnieri G,Guglielmi G,et al.Biomechanics of the spine.Part I:spinal stability［J］.Eur J Radiol,2013,82(1):118-126.
［5］ Xiao JR.Spinal tumor surgery［M］.Shanghai:Shanghai Science and Technology Press,2004:385-399.［肖建如.脊柱肿瘤外科学［M］.上海:上海科技出版社，2004:385-399.］
［6］Wu YL,Chang CY,Hsu SS,et al.Intraspinal tumors:analysis of 184 patients treated surgically［J］.J Chin Med Assoc,2014,77(12):626-629.
［7］Bansal S,Ailawadhi P,Suri A,et al.Ten years' experience in the management of spinal intramedullary tumors in a single institution［J］.Clin Neurosci,2013,20(2):292-298.
［8］Li QD.Clinical analysis of the intraspinal tumors of 107 cases［J］.Shaanxi Oncol Med,2002,10(2):110-111.［厉庆德.椎管内肿瘤107例临床分析［J］.陕西肿瘤医学，2002,10(2):110-111.］
［9］Tredway TL.Minimally invasive approaches for the treatment of intramedullary spinal tumors［J］.Neurosurg Clin N Am,2014,25(2):327-336.
［10］Korn A,Halevi D,Lidar Z,et al.Intraoperative neurophysiological monitoring during resection of intradural extramedullary spinal cord tumors:experience with 100 cases［J］.Acta Neurochir (Wien),2015,157(5):819-830.
［11］Kumar R,Banerjee S.Management and functional outcome of intramedullary spinal cord tumors:A prospective clinical study［J］.Asian J Neurosurg,2014,9(4):177-181.
［12］Zhang J,Zhou XS.Progressin diagnosis and surgical staging of spinal column tumor［J］.Chin J General Practice,2011,9(2):277-279.［张靖，周新社.脊柱肿瘤的诊断和外科分期研究进展［J］.中华全科医学，2011,9(2):277-279.］
［13］Kim CH,Chung CK,Sohn S,et al.Less invasive palliative surgeryfor spinal metastases［J］.J Surg Oncol,2013,108(7):499-503.
［14］Zhang J,Wang Y,Han K,et al.Percutaneous vertebroplasty combined with zoledronic acid for the treatment of painful osteolytic spinal metastases in patients with breast cancer［J］.J Vasc Interv Ｒadiol,2013,24(12):1861-1867.
［15］Shirasawa H,Ishii K,Iwanami A,et al.Pediatric myxopapillary ependymoma treated with subtotal resection and radiation therapy:a case report and review of the literature［J］.Spinal Cord,2014,52(Suppl 2):S18-S20.
［16］De Verdelhan O,Haegelen C,Carsin-Nicol B,et al.MR imaging features of spinal schwannomas and meningiomas［J］.J Neuroradiol,2005,32(1):42-49.
［17］Mccormick PC.Microsurgical resection of intramedullary spinal cord ependymoma［J］.Neurosurg Focus,2014,37(Suppl2):9.
［18］Bydon M,Gokaslan ZL.Spinal meningioma resection［J］.World Neurosurg,2015,83(6):1032-1033.
［19］Wang ZC,Zhang JT,Yang SH,et al.Surgical treatment of the intramedullary spinal cord tumors［J］.Chin J Neurosurg,1997,13(3):128-134.［王忠诚，张俊廷，杨少华，等.脊髓髓内肿瘤的手术治疗［J］.中华神经外科杂志，1997,13(3):128-134.］
［20］Shao QD,Yan X,Li B.Diagnosis and surgical treatment of intraspinal tumors［J］.J Cervicodynia Lumbodynia,2007,28(1):68-69.［邵擎东，严旭，李博，等.椎管内肿瘤的诊断与手术治疗［J］.颈腰痛杂志，2007,28(1):68-69.］
［21］Liu L,Li XZ,Yang B,et al.Surgical treatment of intraspinal meningiomas:Report of 70 cases［J］.Chin J Neuro-Oncol,2007,5(1):13-16.［刘磊，李学真，杨宝，等.椎管内脊膜瘤的显微外科治疗-附70例临床报告［J］.中国神经肿瘤杂志，2007,5(1):13-16.］
［22］Saito T,Arizono T,Maeda T,et al.A novel technique for surgical resection of spinal meningioma［J］.Spine,2001,26(16):1805-1808.
［23］Xie JC,Wang ZY,Ma CC,et al.Surgical treatment of 660 consecutive cases of spinal cord tumor［J］.Chin J Minimally Invasive Surg,2009,9(10):940-945.［谢京城，王振宇，马长城，等.660例椎管内肿瘤的手术治疗［J］.中国微创外科杂志，2009,9(10):940-945.］

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Last Update: 2016-01-29