脊髓粘液乳头型室管膜瘤的显微手术治疗（附18例报道）

目的 探讨脊髓粘液乳头型室管膜瘤（MPE）临床特点及显微手术治疗的疗效。方法 回顾性分析2013年1月至2020年1月手术治疗并经病理证的18例脊髓MPE的临床资料。结果 腰痛是最常见首诊症状，其次为大小便功能异常、运动功能障碍及感觉异常；病程2周~20年，平均33.3个月。18例共行28次手术，3例行3次手术，4例行2次手术；首次手术肿瘤全切除6例，非全切除12例；肿瘤全切除率为33.33%。术后随访2个月~7年，平均33.2个月，死亡1例，年总生存率达95.8%；首次术后复发8例，1、2年复发率为5.56%、33.33%，总复发率为44.44%。末次随访，McCormick分级Ⅰ级4例，Ⅱ级2例，Ⅲ级11例，Ⅳ级1例；术后神经功能改善6例，恶化12例。结论 显微手术是脊髓MPE首选治疗方法，首次手术未全切除肿瘤，易出现肿瘤复发，早诊断、早治疗不仅有助于延长病人生存期，也有利于提高病人术后生活质量。

Microsurgery for patients with spinal myxopapillary ependymoma (report of 18 cases)

Objective To investigate the clinical characteristics of spinal myxopapillary ependymomas (sMPE) and the curative effect of microsurgery on the patients with sMPE. Methods The clinical data of 18 patients with sMPE who underwent microsurgery from January 2013 to January 2020 were retrospectively analyzed. Results Low back pain was the most common symptom followed by abnormal defecation, motor dysfunction and abnormal sensation. The disease course of these 18 patients ranged from 2 weeks to 20 years, with an average of 33.3 months. Twenty-enght operations were performed on these 18 patients, of whom 3 patients received 3 operations and 4 patients received 2 operations. Total tumor resection was achieved in 6 patients and non-total in 12 after the first operation. The total resection rate was 33.33%. Postoperative follow-up ranged from 2 months to 7 years, with an average of 33.2 months. 1 patient died. The total annual survival rate was 95.8%. Postoperative recurrence occurred in 8 patients after the first operation. The 1- and 2-year recurrence rates were 5.56% and 33.33%, respectively. The total recurrence rate was 44.44%. McCormick grade Ⅰ was achieved in 4 patients, grade Ⅱ in 2, grade Ⅲ in 11, and grade Ⅳ in 1 at the last follow up. Neurological function was improved in 6 patients and worsened in 12. Conclusions Microsurgery is the preferred method of treatment for the patients with sMPE. The tumors are prone to recurrence in the MPE patients whose tumors are not totally resected after the first operation. Early diagnosis and early treatment not only help to prolong the survival time of sMPE patients, but also improve their qualities of life.