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최원림,신원한,조성진,김범태,최순관,변박장,Choi, Weon-Rim,Shin, Won-Han,Cho, Sung-Jin,Kim, Bum-Tae,Choi, Soon-Kwan,Byun, Bak-Jang 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1
Objective : This study was undertaken to evaluate operative results and prognosis according to preoperative clinical status and histopathological finding of spinal cord tumor. Methods : We analyzed of clinical feature, tumor location, histopathologic finding, operative results and prognosis in 55 patients with spinal cord tumor during last 10 years. Results : 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidences were in the 5th & 7th decade of life, and the ratio of male to female was 1.2:1. 2) The most common histopathologic type was neurinoma(41.9%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%) and in the intradural extramedullary space(30 cases, 54.5%). 4) The most common initial clinical feature was pain in 20 cases(36.4%). For neurologic status on admission, 30 cases(54.5%) showed motor disturbance. 5) In radiologic studies, there were abnormal finding in 21 cases from plain X-rays among 37 cases. The entire 20 cases in when myelography was done showed subarachnoid blockade, either complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, revealed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure. 6) The total removal was possible in 36 cases(65.5%), subtotal removal in 17 cases(30.9%) and biopsy in 2 cases (3.6%). Nineteen cases(90.5%) among 21 cases with preoperative radiculopathy group showed recovery or improvement, where as only 11 cases(36.7%) among 30 cases with preoperative motor weakness group showed recovery or improvement, with statistically significant difference(p<0.01). Pathologically, 26 cases(83.9%) among 31 cases of neurinoma and meningioma showed postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma recovered. Postoperative complication noted in 5 cases(9.1%), and were noted postoperative hematoma, pneumonia, pulmonary edema and spinal cord infarction. Conclusion : Preoperative neurologic status and histopathologic finding are considered important factors of Postoperative outcome in patients with spinal cord tumor.
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최원림,신원한 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1
A retrospective study of clinical feature, tumor location, histopathologic finding, operative results and prognosis were carried out in a series of 55 patients who were performed operation between January 1, 1989 and December 31, 1998 at the Department of Neurosurgery of Soonchunhyang University Hospital. The results were summurized as followings 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidence occurs in the 5th & 7th decade of life, and the ratio of male to female was 1.2 : 1. 2) The most common histopathologic type was neurinoma in 23 cases(41.9%), and the rests were metastatic tumor in 12 cases(21.8%), meningioma in 8 cases(14.6%), lipoma in 3 cases(5.5%), astrocytoma in 2 cases(3.6%), ependymoma in 2 cases(3.6%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%), in the intradural extramedullary space(30 cases, 54.5%), extradural space(19 cases, 34.5%), intramedullary space(5 cases, 9.1%), and intradural and extradural space(1 case, 1.8%) according to location into spinal canal. 4) The most common initial clinical feature was pain in 20 cases(36.4%), and the rest were motor disturbance(15 cases, 27.3%), motor & sensory disturbance(10 cases, 18.2%), sensory disturbance(6 cases, 10.9%), sphincter disturbance(2 cases, 3.6%), no symptom(2 cases, 3.6%). In neurologic status on admission, 30 cases(54.5%) were motor disturbance and the rest were radiculopathy or sensory changes(21 cases, 38.2%), sphincter disturbance(1 case, 1.8%), no symptom(3 cases, 5.5%). 5) In radiologic study, there were abnormal finding in 21 cases of plain X-rays among 37cases. The entire 20 cases of myelography showed subarachnoid blockade, complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, showed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure in entire 29 cases. 6) The total removal was possible in 36 cases(65.5%), subtotal removal was in 17 cases(30.9%) and biopsy was in 2 cases(3.6%). Postoperative 31 cases(56.3%) were recovery or improved, 21 cases(38.2%) were stationary state, and 3 cases(5.5%) were progression of clinical symptom and neurologic status. Nineteen cases(90.5%) among 21 cases of preoperative radiculopathy group were recovery or improvement but only 11 cases(36.7%) among 30 cases of preoperative motor weakness group were recovery or improvement, that was statistically significance(p 0.01). Pathologically, 26 cases among 31 cases of neurinoma and meningioma were postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma were recovery. Also, that was statistically significance(p <0.05). Postoperative complication were in 5 cases(9.1%) that were postoperative hematoma, pneumonia, pulmonary edema, and spinal cord infarction. According to the above results, preoperative neurologic status and histopathologic finding were important factor of postoperative outcome in spinal cord tumor.
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