儿童脊柱肿瘤

目的 探讨儿童脊柱肿瘤的临床特点、诊断、治疗方法及预后。方法回顾性分析我院1991年1月-2003年10月治疗的16岁以下脊柱肿瘤及瘤样病变44例，男27例，女17例；平均9．6岁。良性肿瘤（包括瘤样病变）38例，恶性肿瘤3例，转移瘤3例。疼痛39例，肿块9例，侧弯或斜颈8例，不同程度神经损害14例。18例初诊不确定或与最后诊断不符。发病至确诊时间平均8．5个月。手术治疗17例，化疗10例，放疗8例，手术与化疗1例，手术与放疗2例，放弃治疗3例，观察3例。结果围手术并发症4例。35例获平均5．5年随访。良性肿瘤及瘤样病变患儿手术或放疗或化疗后疗效较满意，所有患儿的局部疼痛消失，除1例外，所有患儿神经功能均有改善，3例病变复发再次手术。4例出现后弯畸形。6例恶性肿瘤和转移瘤患儿全部死亡。2例嗜酸性肉芽肿患儿症状消失，病变得到控制。结论对于儿童脊柱肿瘤，根据肿瘤的性质选择恰当的治疗方法，良性肿瘤与肿瘤样病变预后良好，恶性肿瘤及转移瘤治疗效果欠佳。

Spinal tumors in children

Objective To study the clinical features,diagnosis,management and prognosis of spine tumors in children.Methods 44 children(27 male and 17 female) below the age of 16 years with spine tumors admitted from January 1991 to October 2003 were analyzed.The average age was(9.6) years.There were 38 benign tumors(including tumor-like lesions),3 malignant tumors,3 metastatic tumors.Clinically,patients present with pain(n = 39),tumor mass(n= 9),scoliosis or wryneck(n=8) and varying degree of nerve lesion(n=14).In 18 patients,the diagnosis was not obvious initially.The average period to achieve a definite diagnosis was (8.5) months.Seventeen cases were operated,10 treated with chemotherapy,8 with radiotherapy,1 with combined operation /chemotherapy,and 2 with combined operation/radiotherapy.Three patients refused further treatment.3 cases were observed.Results There were 4 peri-operative complications.The average follow-up was(5.5) years in 35 cases.All the benign tumors and tumor-like lesions treated with operation or chemotherapy or radiotherapy had satisfactory outcomes and the local pain subsided.The nerve function of all patients improved with exception of one.Three tumors recurred and were resected again.Four patients had kyphosis.All 6 patients with malignant and/or metastatic tumors died.The 2 eosinophilic granuloma subsided with time. Conclusions The benign tumors and tumor-like lesions of spine below 16 years can be managed with a satisfactory outcomes. Therapeutic result in malignant and metastatic tumors is not good.