Clinical Analysis Of Pediatric Intraspinal Space-occupying Lesions

ObjectiveTo explore the clinical characteristics, diagnosis and treatmentexperience of pediatric intraspinal space-occupying lesions.MethodsA total of68pediatric intraspinal space-occupying lesions casesadmitted into children s hospital of Chongqing medical university fromJanuary2003to December2013were analyzed retrospectively.ResultsThe68patients include42male and26females, Ranged from2monthsto12.75years old, with an average age of (6.19土3.55) years old. Theinterval lasted4days to1year from the onset of the syndrome to beingtreatment, with an average of3.4months. The main clinical manifestationsinclude32cases of limb dyskinesia, pain in30cases, urine and stooldisturbance in20cases,7cases of sense damage. Spinal magnetic resonanceimaging (MRI) had a positive rate of100%, suggesting that abnormal signalwithin the lesion spinal segments,14cases were intramedullary lesionoccupying(20.6%).30cases were extramedullary space-occupying (44.1%),16cases were epidural space-occupying(23.5%),2case involving the intramedullary and extramedullary both(2.9%),6cases were mergerinvolving subdural and epidural extramedullary(8.8%). Occur in the cervicalspinal cord in6cases(8.8%), cervical thoracic in6cases(8.8%),20cases ofthoracic (29.4%), thoracolumbar in16cases (23.5%), lumbar in6cases(8.8%),14cases of lumbosacral (20.6%).65cases of the total group acceptthe surgery,total resection was achieved in37cases(56.9%),6cases(9.2%)of subtotal ectomy,19cases (29.2%) partial resection, biopsy in3cases;3cases of non-surgical treatment. All patients were diagnosed by surgicalpathology, laboratory tests as well as imaging diagnosis. There were spinaltumors in62cases(88.2%), non-neoplastic spinal occupying in6cases(11.8%). The top3pathology types are: dermoid/epidermoid cyst in15cases(22.1%), nerve Sheath Tumors in23cases (33.8%), lipoma in7cases(10.3%). Clinical symptoms and neurological dysfunction havevarying degrees of improvement in55cases,8cases no significant changesand1case got worse.ConclusionPediatric intraspinal space-occupying lesions include spinal cord tumorand non-tumor occupying. The most common type was embryonic residualtumor(such as dermoid cyst, teratoma, lipoma, etc.), followed byschwannoma, ependymoma, etc., and vascular malformations, hematoma,tuberculosis and other non-neoplastic placeholder. the most common clinicalmanifestations is limb dyskinesia, followed by pain, urine and stool disturbance as well as sense damage. MRI can show a reliable evidence andcan be the initial choices in diagnosis. Surgical resection is the first selectionto cure pediatric intraspinal space-occupying lesions. There weresignificantly different rates of total resection of the common types of lesions.Postoperative neurological in most of cases have varying degrees ofimprovement.