Microsurgical Treatment And Prognosis Of Ependymoma Of The Spinal Cord

[Objective]A retrospective analysis was conducted on the preoperative data,diagnosis and treatment process and postoperative prognosis of 31 patients with spinal ependyma who were treated by microsurgery and diagnosed by postoperative pathology in the First Affiliated Hospital of Kunming Medical University from January 2017 to June 2020 in the First Department of Neurosurgery.Statistical methods were used to analyze the data.Through the discussion of clinical microsurgical treatment of spinal ependymoma and the related factors affecting the prognosis of patients,some guidance on the clinical diagnosis and treatment of this disease was obtained.[Methods]Collect the First Affiliated Hospital of Kunming Medical University subject outside nerve in January 2017 to June 2020 were 31 cases by microsurgical operative and postoperative pathological diagnosis for patients with spinal ependymoma in patients with clinical data.The factors included age,gender,tumor location,preoperative defecation difficulty or incontinence,syringomyelia,pathological grade of tumor,preoperative spinal nerve function,preoperative symptom duration,tumor involved spinal cord length,postoperative spinal nerve function and intraoperative resection range.We applied statistical methods to analyze the clinical microsurgical management of spinal cord ependymomas and associated factors influencing the prognosis of patients.[Results]In this study,there were 31 cases of spinal ependymoma.The first symptom of 22 cases was limb motor dysfunction(including muscle weakness of limbs).11 cases had spontaneous limb pain or local pain.19 cases of limb or partial paresthesia(paralysis or hypoesthesia/hypersensitivity/separation of sensations);Sphincter dysfunction(dyspepsia or incontinence)occurred in 4 patients.In this study,among the 31 patients,total resection was achieved in 30 cases and subtotal resection was achieved in 1 case,with a total resection rate of 96.8%.The clinical symptoms of 29 of the 31 patients were relieved to varying degrees at discharge,and the clinical symptoms of the remaining 2 patients showed no significant difference between preoperative and postoperative symptoms.In this study,the mean postoperative follow-up was 24.6 months.During the follow-up,the neurological function of 10 cases was completely recovered,19 cases showed significant improvement in neurological function compared with that before surgery,2 cases showed no significant change in neurological function after surgery,and 2 cases had sphincter dysfunction.Among the 31 patients in this group,1 patient had tumor recurrence at the 12th month of follow-up and needed surgical treatment again,while the other patients did not have significant recurrence during the follow-up.[Conclusions]1.Microsurgical resection is the preferred treatment for spinal ependymoma.Once diagnosed,surgery should be performed as soon as possible.During surgery,the tumor should be completely removed,while the spinal nerve function should be retained to the maximum extent,so as to reduce the recurrence rate of tumor and achieve a better prognosis.2.The duration of disease,preoperative spinal cord function,tumor involved segment and surgical resection range are the main factors affecting the prognosis of patients.The shorter the duration of disease,the better the preoperative spinal cord function and the smaller the tumor involved range,the better the prognosis;otherwise,the worse the prognosis.