CAJ | 학술논문

目的：探讨儿童及青少年脊柱肿瘤的临床特点、诊断、治疗及预后。方法回顾性分析2003年5月至2013年10月，我院收治的3～18岁脊柱肿瘤患者共35例，分别收集其临床病历、影像学资料及随访资料，并对其进行详细分析。结果共收集病例35例，男26例，女9例，平均年龄13.6岁，其中良性肿瘤29例，恶性肿瘤6例。发生部位：颈椎6例，胸椎14例，腰椎13例，骶椎2例。发生症状至明确诊断时间：良性肿瘤14.3个月，恶性肿瘤2.3个月，平均12.3个月。主要症状：疼痛31例，神经功能障碍20例。良性肿瘤中手术治疗27例，单纯放疗2例。恶性肿瘤中手术治疗且联合放疗和(或)化疗5例，单纯行放化疗1例。所有病例平均随访时间4.7年。良性肿瘤治疗后疼痛症状大多减轻或消失，神经症状不同程度减轻或恢复；恶性肿瘤3例死亡，1例肺部转移。结论儿童及青少年脊柱肿瘤发病率低，良性及原发性肿瘤较多，疼痛及神经功能障碍是其主要症状。影像学检查对于尽快明确肿瘤诊断及制订合适的治疗方案具有重要作用。手术治疗目前是儿童及青少年脊柱肿瘤最主要的治疗方法，而脊柱稳定性的重建则是其关键步骤且是一个棘手的难题。
목적：탐토인동급청소년척주종류적림상특점、진단、치료급예후。방법회고성분석2003년5월지2013년10월，아원수치적3～18세척주종류환자공35례，분별수집기림상병력、영상학자료급수방자료，병대기진행상세분석。결과공수집병례35례，남26례，녀9례，평균년령13.6세，기중량성종류29례，악성종류6례。발생부위：경추6례，흉추14례，요추13례，저추2례。발생증상지명학진단시간：량성종류14.3개월，악성종류2.3개월，평균12.3개월。주요증상：동통31례，신경공능장애20례。량성종류중수술치료27례，단순방료2례。악성종류중수술치료차연합방료화(혹)화료5례，단순행방화료1례。소유병례평균수방시간4.7년。량성종류치료후동통증상대다감경혹소실，신경증상불동정도감경혹회복；악성종류3례사망，1례폐부전이。결론인동급청소년척주종류발병솔저，량성급원발성종류교다，동통급신경공능장애시기주요증상。영상학검사대우진쾌명학종류진단급제정합괄적치료방안구유중요작용。수술치료목전시인동급청소년척주종류최주요적치료방법，이척주은정성적중건칙시기관건보취차시일개극수적난제。
Objective To study clinical features, diagnosis, treatment strategy and prognosis of spinal tumors in children and adolescents.Methods Thirty-ifve patients were retrospectively investigated from May 2003 to October 2013. The age of patients ranged from 3 to 18 years. Clinical medical history, radiographic records and follow-up data were reviewed retrospectively.Results There were 26 males and 9 females. The mean age was 13.6 years. There were 29 cases of benign tumors and 6 malignant tumors. Tumor locations: 14 cases were of cervical vertebrae, 14 thoracic vertebrae, 13 lumbar vertebrae, 2 sacral vertebrae. Period from onset of symptoms to diagnosis: 14.3 months in benign tumors, 2.3 months in malignant tumors, average 12.3 months. Main manifestations: pain (n=31, 88.6% ) and neurologic involvement ( n=20, 57.1% ). Twenty-seven cases underwent surgical treatment, while 2 cases radiotherapy alone. The mean follow-up period was 4.7 years. Pain was mostly relieved or disappeared after the treatment, and neurologic symptoms were also reduced or disappeared in benign tumors. Three cases of malignant tumors died, and 1 case of them was with lung metastasis.Conclusions Incidence of spinal tumors in children and adolescents is lower. Benign and primary tumors are more common with main manifestations of pain and neurologic dysfunction. Imaging examination is very important for diagnosis and proper treatment plan. Surgical treatment is mostly applied, while spinal stability reconstruction is a key step and intractable problem.