Wang Qi,Wang Jinhu,Tang Yinbing,et al.Managements of paravertebral tumors with spinal canal involvement in children:a report of 75 cases at a single center[J].Journal of Clinical Pediatric Surgery,,23():1160-1165.[doi:10.3760/cma.j.cn101785-202403033-010]
Managements of paravertebral tumors with spinal canal involvement in children:a report of 75 cases at a single center
- Keywords:
- Paraspinal; Neoplasms; Neuroblastoma; Spinal Canal; Neoplasm Metastasis; Surgical Procedures; Operative; Metastasectomy; Treatment Outcome
- Abstract:
- Objective To explore the clinical diagnoses and treatments of paravertebral tumors plus spinal canal involvement (SCI) and evaluate the safety of intraspinal lesion resection and the effectiveness of tumor local control. Methods For this retrospective study,the relevant clinical data were reviewed for 75 childrens with paravertebral tumors plus SCI undergoing intraspinal lesion resection from April 2015 to March 2023.Pathological types,neurological function outcomes,incidence of scoliosis and local tumor control were recorded and the subgroup of neuroblastoma patients with the highest proportion was statistically examined. Results There were neuroblastoma (n=53) and other tumors (n=22).There were no preoperative neurological symptoms (Group A,n=34),mild neurological dysfunction (Group B,n=26) and severe neurological dysfunction (Group C,n=15).In Group A,7(7/34) of transient postoperative neurological dysfunction normalized in the long term.In Group B,neurological dysfunction worsened immediately post-operation (n=2),21(21/26) had significant long-term improvement in neurological function and 5/26 showed no significant improvement.In Group C,12(12/15) had marked postoperative improvement in neurological function and normalized (n=2).Analysis based upon surgical timing,improvement rate of neurological function was higher in emergency surgery group than that in non-emergency surgery group with statistically significant differences (P=0.038).Among 13 cases of postoperative scoliosis,scoliosis pre-existed (n=3) and grade was Ⅰ(n=6),Ⅱ(n=5) and Ⅲ(n=2).Among 10 cases of neuroblastoma,scoliosis pre-existed (n=2) and grade was Ⅰ(n=5) and Ⅱ(n=5).Residue or recurrence occurred in 3.8%(2/53). Conclusions In children with paravertebral tumors plus SCI,resection of intraspinal lesions is essential for protecting neurological function and achieving excellent local tumor control.Based upon modern surgical techniques and monitoring technology,intraspinal lesion resection is both safe and feasible.
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Memo
收稿日期:2024-3-18。
基金项目:浙江省尖兵领雁研发攻关计划项目(2024CO3181)
通讯作者:舒强,Email:shuqiang@zju.edu.cn