Spinal schwannomas are the second most common form of primary intradural spinal tumor. Despite being benign, they may cause spinal cord compression and subsequently acute or chronic neurological dysfunction. The primary treatment is surgical resection. The aim of this study was to identify pre- and postoperative predictors of favorable outcomes after surgical treatment for spinal schwannoma. All adult patients surgically treated for spinal schwannoma between 2006 and 2020 were eligible for inclusion. Medical records and imaging data were retrospectively reviewed. The primary outcome measures were neurological improvement according to the modified McCormick Scale (mMC) and changes in motor deficit, sensory deficit, gait disturbance, bladder dysfunction, and pain at long-term follow-up. In total, 180 patients with a median follow-up time of 4.4 years were included. Pain was the most common presenting symptom (87%). The median time between symptom presentation and surgery was 12 months, while the median time between diagnosis (first MRI) and surgery was 3 months. Gross total resection (GTR) was achieved in 150 (83%) patients and the nerve root could be preserved in 133 (74%) patients. A postoperative complication occurred in 10 patients (5.6%). There were significant postoperative improvements in terms of motor, sensory, gait, and bladder functions, as well as pain (p< 0.001). Of these symptoms, bladder dysfunction was the one most often improved, with complete symptom resolution in all cases. However, no other predictors of improvement could be identified. There were three cases of recurrence after GTR and nine cases of regrowth after STR. Reoperation was performed in six (3.3%) cases. GTR was associated with a significant improvement in neurological status at long-term follow-up and increased the chance of progression-free survival.
脊髓神经鞘瘤是第二常见的原发性硬膜内脊髓肿瘤。尽管属于良性肿瘤，它们仍可能导致脊髓压迫，进而引发急性或慢性神经功能障碍。手术切除是其主要治疗方法。本研究旨在确定脊髓神经鞘瘤手术治疗后良好结局的术前及术后预测因素。2006年至2020年间所有接受手术治疗的成年脊髓神经鞘瘤患者均符合纳入标准。研究对病历及影像学资料进行了回顾性分析。主要结局指标包括：根据改良McCormick量表（mMC）评估的神经功能改善情况，以及长期随访中运动障碍、感觉障碍、步态异常、膀胱功能障碍和疼痛的变化。共纳入180例患者，中位随访时间为4.4年。疼痛是最常见的首发症状（87%）。从症状出现到手术的中位时间为12个月，而从确诊（首次MRI检查）到手术的中位时间为3个月。150例（83%）患者实现了肿瘤全切除（GTR），133例（74%）患者成功保留了神经根。术后并发症发生率为5.6%（10例）。术后患者在运动、感觉、步态、膀胱功能及疼痛方面均有显著改善（p<0.001）。其中膀胱功能障碍改善最为显著，所有病例症状均完全消失。但研究未发现其他具有统计学意义的改善预测因素。全切除组出现3例复发，次全切除组出现9例再生。6例（3.3%）患者接受了再次手术。长期随访显示，肿瘤全切除与神经功能状态的显著改善相关，并提高了无进展生存率。
肿瘤(癌症)患者之家