척수종양의 임상적 분석 = Clinical Analysis of Spinal Cord Tumor

다국어 초록 (Multilingual Abstract)

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.