Microsurgery For Subdural Extramedullary Mutiple Tumors In Intraspinal Canal And The Analysis Of Prognosis

Objective:To discuss the microneurosurgery for subdural extramedullary multiple tumors in intraspinal canal, analyze the postoperative factors related on prognosis of patients with subdural extramedullary mutiple tumors in intraspinal canal.Method:13 cases of patients with subdural extramedullary mutiple tumors in the spinal resected by microneurosurgery in The First Affiliated Hospital of Kunming Medical University from April 2010 to April 2016 were analyzed retrospectively, including clinical symptoms, imageological manifestations,diagnosis,operation and outcomes, tumors histological types. The incidence of NF 2 and companying intracranial tumor in the all patients with subdural extramedullary multiple tumors were analyzed.The preoperative and postoperative status of spinal cord neurological function were scored by IJOA scoring system in the all patients. Compared the preoperative spinal cord neurological function score with postoperative spinal cord neurological function score and analyzed by paired t-test, the correlation between gender, age, course time, preoperative spinal cord neurological function score, the extent of tumor resection and prognosis were analyzed by multiple linear regression. All data was analyzed by the SPSS 17.0 statistical analysis software.Results:All tumors resected by microneurosurgery were confirmed by pathological examination after operation. The cases included the male in 11 cases, female in 2 cases,age 13 to 54(31.6±11.3)years, the mean course time was 2.5 months,8 schwannoma,2 neurofibroma,2 spinal meningioma,1 schwannoma with spinal meningioma.3 cases of schwannoma were totally resected,5 case of schwannoma’s responsible tumor were resected; 1 case of neurofibroma was totally resected,1 case of neurofibroma’s responsible tumor was resected,; 1 case of schwannoma with spinal meningioma’s responsible tumor was resected.There was no early postoperative complications, no deterioration or deaths. After the analysis of data, NF 2 and companying intracranial tumor get a high incidence of subdural extramedullary multiple tumors.Compared the preoperative spinal cord neurological function score with postoperative spinal cord neurological function score and analyzed by paired t-test, it showed there was a significant difference between postoperative spinal cord neurological function score and preoperative spinal cord neurological function score, and postoperative spinal cord neurological function was significantly better than preoperative spinal cord neurological function. We used the multiple linear regression to analyze the correlation between gender, age, course time, preoperative spinal cord neurological function score, the extent of tumor resection and prognosis, it indicated significantly negative correlation between course time and postoperative spinal cord neurological function score, it means that the longer course time is, the worse prognosis will be.Conclusion:1.Microneurosurgery is a preferred effective treatment for subdural extramedullary mutiple tumors in intraspinal canal at present,Surgical methods should be decided combining with the actual situation by doctors.2.The longer course time is, the worse prognosis of patients with subdural extramedullary mutiple tumors in intraspinal canal will be, that patients should get neurosurgery at early stage after symptoms appeared.3.The incidence of NF 2 and companying intracranial tumor in the all patients with subdural extramedullary multiple tumors is high,they should be taken intracranial imaging examination before operation for assessing surgical risks and avoiding missed diagnosis.