Analysis Of Influencing Factors For Prognosis Of Postoperative Neurologic Function Of Spinal Canal Tumors

Objective:To explore the related factors affecting the prognosis of postoperative neurological function of spinal canal tumors and improve the clinical efficacy.Method:Retrospective analysis was performed on 87 patients who underwent microexcision of spinal canal tumors in the Department of Neurosurgery of our hospital from September 2018 to September 2020.The basic information was collected through the case system,and the postoperative efficacy was collected through outpatient visits and telephone follow-up.According to the improvement rate of Japan Orthopaedic Association(JOA)score before and after surgery(improvement rate of JOA score after treatment =[(post-treatment score-pre-treatment score)/ 17(29)-pre-treatment score]×100%.They were divided into effective group and ineffective group(100% improvement rate was cure,improvement rate greater than60% was significant effect,25-60% was effective,and less than 25% was ineffective;25%-100% is the effective group,and less than 25% is the invalid group).Data including gender,age,height,weight,hypertension,diabetes,smoking history,alcohol consumption history,duration of disease,operative time,intraoperative blood loss,tumor segment(neck,chest and waist),tumor size,tumor location,pathological properties of tumor,tumor resection,and postoperative hyperbaric oxygen chamber treatment were collected in the two groups.All data are statistically analyzed by SPSS25.0 software,independent sample t-test is used to analyze the data that obey normal distribution,nonparametric rank sum test is used to analyze the data that do not obey normal distribution,and enumeration data were analyzed by chi-square or rank sum test.First of all,univariate analysis of all variables was carried out according to the corresponding test method,and then the indexes with significant difference in univariate analysis were analyzed by multivariate Logistic regression analysis,and the independent risk factors that may affect the prognosis of neurological function after operation of intraspinal tumors were obtained.Result:1.A total of 87 patients were included,including 76 effective patients,11 ineffective patients and 12.64% ineffective patients.2.Univariate analysis showed that there were significant differences in tumor segment(P=0.047),tumor location(P=0.000),pathological properties of tumor(P=0.000)and preoperative JOA score(P=0.045)between the two groups(P<0.05).And sex(P = 0.656),age(P = 0.932),the length of the course of the disease(P =0.843),surgical duration(P = 0.860),intraoperative blood loss(P = 0.493)and tumor size(P = 0.903),high blood pressure history(P = 0.871),a history of diabetes(P =0.796),smoking history(P = 0.381),alcohol(P = 0.702),and adjacent segmental degenerative diseases lesions(P = 0.444),intraoperative use of artificial dura mater(P= 0.092),postoperative hyperbaric oxygen therapy(P = 0.224),the complete tumor(P= 0.702).There was no statistical difference between the two groups(P>0.05).3.Multivariate analysis showed that there were statistical differences in tumor location(P=0.006),tumor segment(P=0.044)and preoperative JOA score(P=0.004)between the two groups(P<0.05),while there was no statistical difference in pathological properties of tumor(P=0.349)between the two groups(P>0.05).Conclusion:Studies have shown that tumor location,tumor segment and preoperative JOA score are independent risk factors for the prognosis of neurologic function in spinal tumors.