摘要
目的 本研究旨在评估脊柱神经鞘瘤复发和再生长的危险因素,以期为临床诊治提供参考.方法 回顾分析本院 2020 年 1 月至 2022 年 1 月,接受脊髓神经鞘瘤切除术的 65 例患者的临床资料.对比术后复发或残余肿瘤再生>10%的患者(R+组)与无复发或再生患者(R-组).采用多因素 Logistic 回归分析危险因素对复发和再生的影响.结果 65 例平均随访 24 个月,累及颈椎(14 例)、胸椎(25 例)和腰椎(26 例),位置在硬膜内的占 65%,硬膜外的占 17%,硬膜内硬膜外的占 18%.术后复发 4 例(6.2%),7 例(10.8%)发生再生长.单因素分析显示,R+组(11 例)和 R-组(54 例)在 Sridhar 肿瘤分类、巨大肿瘤(Sridhar 分级 Ⅱ、Ⅳb 和 Ⅴ 级)、左侧和颅尾部肿瘤大小、最大直径、手术时间、出血量、次全切除、再手术、融合术和随访时间等方面有显著差异.多因素 Logistic 回归分析显示巨大肿瘤(Sridhar 分类 Ⅱ、Ⅳb 和Ⅴ 型)是复发和再生长的独立危险因素.结论 脊柱神经鞘瘤复发和再生长率 2 年内约为 16.9%,且巨大肿瘤(Sridhar分类 Ⅱ、Ⅳb和 Ⅴ型)是复发和再生长的独立危险因素.
Abstract
Objective To evaluate the risk factors for recurrence and regrowth of spinal neurilemmoma,further provide references for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on the clinical data of 65 patients who underwent spinal cord schwannoma resection in our hospital from January 2020 to January 2022.Patients with postoperative recurrence or residual tumor regeneration>10%(R+group)were compared with those without recurrence or regeneration(R-group).Multiple logistic regression analysis was used to investigate the impact of risk factors on recurrence and regeneration.Results The average follow-up time of 65 patients was 24 months,involving cervical vertebrae(14 cases),thoracic vertebrae(25 cases),and lumbar vertebrae(26 cases);65%located within the dura mater,17%located outside the dura mater,and 18%located inside the dura mater.Postoperative recurrence occurred in 4 cases(6.2%),and regrowth occurred in 7 cases(10.8%).Univariate analysis showed significant differences between the R+group(11 cases)and the R-group(54 cases)in Sridhar tumor classification,giant tumor(Sridhar grade Ⅱ,Ⅳb,and Ⅴ),left and posterior cranial tumor size,maximum diameter,surgical time,bleeding volume,subtotal resection,reoperation,fusion surgery,and follow-up time.Multivariate logistic regression analysis showed that giant tumor(Sridhar classification Ⅱ,Ⅳb,and Ⅴ types)was the independent risk factor for recurrence and regrowth.Conclusions The recurrence and regeneration rate of spinal schwannoma is approximately 16.9%within 2 years.Giant tumor(Sridhar classification Ⅱ,Ⅳb,and Ⅴ types)is the independent risk factor for recurrence and regeneration,which is worthy of clinical attention.
基金项目
重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0784)
NETL
NSTL
万方数据