A retrospective analysis of spinal teratomas and spinal lipomas: overlaps and differences in presentation, surgical treatments, and outcomes

IF 4.9 1区医学 Q1 CLINICAL NEUROLOGY

Spine Journal Pub Date : 2025-01-01 DOI:10.1016/j.spinee.2024.08.026

Hongmei Song, Mingxin Yu, Yang Song, Shuanglin Deng

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引用次数: 0

Abstract

BACKGROUND

Spinal teratomas and lipomas, both adult and pediatric cases, are rare diseases with many similarities, but have yet to be systematically compared.

PURPOSE

To systematically compare spinal teratomas and lipomas to optimize management.

STUDY DESIGN

Retrospective.

PATIENT SAMPLE

Symptomatic spinal teratoma and lipoma patients surgically treated at our center.

OUTCOME MEASURES

Anatomical distribution, clinical manifestations, resection status, and outcomes.

METHODS

Spinal teratoma and lipoma patients with complete data treated during 2008 to 2023 in our center were enrolled. Electrophysiological monitoring was routinely performed after 2012. Patient characteristics, anatomical distribution, clinical manifestations, surgical resection, and outcomes were analyzed.

RESULTS

We enrolled 86 teratoma patients (71 adults) and 51 lipoma patients (39 adults). Most tumors were lumbosacral lesions; cervical/thoracic involvement was more common with lipomas. Pain, the most frequent manifestation, was more common in teratomas. Gross total resection (GTR) was achieved in 51.1% and 49% of teratomas and lipomas, respectively. Electrophysiological monitoring increased the GTR rate from 38.8% to 48.6%. Age independently predicted (OR: 1.040, 95% CI: 1.008–1.078) GTR/near-total resection (NTR). Symptom relief occurred in 81.4% teratoma patients and 64.7% lipoma patients. Recurrence/symptomatic progression occurred in 19 teratomas and 7 lipomas after a median of 95 and 115 months, respectively. Adult lipoma patients without spinal dysraphism had lower recurrence rates. GTR (HR: 0.172, 95% CI: 0.02557–0.7028) and lesion length (HR: 1.351, 95% CI: 1.138–1.607) independently predicted recurrence/progression.

CONCLUSIONS

GTR should be pursued for adult/pediatric spinal teratomas and pediatric spinal lipomas. For adult spinal lipoma patients without dysraphism, conservative surgery could be considered.

查看原文本刊更多论文

脊柱畸胎瘤和脊柱脂肪瘤的回顾性分析：表现形式、手术治疗和结果的重叠与差异。

背景脊柱畸胎瘤和脂肪瘤，无论是成人病例还是儿童病例，都是罕见的疾病，有许多相似之处，但尚未进行系统比较。目的系统比较脊柱畸胎瘤和脂肪瘤，以优化管理。研究设计回顾性患者样本：在本中心接受手术治疗的无症状脊柱畸胎瘤和脂肪瘤患者.结果测量解剖分布、临床表现、切除情况和结果.方法纳入2008-2023年期间在本中心接受治疗且资料完整的脊柱畸胎瘤和脂肪瘤患者。2012年后常规进行电生理监测。分析了患者特征、解剖分布、临床表现、手术切除情况和结果。大多数肿瘤为腰骶部病变；颈部/胸部受累在脂肪瘤中更为常见。疼痛是最常见的表现，在畸胎瘤中更为常见。畸胎瘤和脂肪瘤中分别有51.1%和49%实现了大体全切除（GTR）。电生理监测将全切除率从38.8%提高到48.6%。年龄是GTR/近全切（NTR）的独立预测因素（OR：1.040，95% CI：1.008-1.078）。81.4%的畸胎瘤患者和64.7%的脂肪瘤患者症状缓解。分别有 19 例畸胎瘤和 7 例脂肪瘤患者在中位 95 个月和 115 个月后出现复发/症状进展。没有脊柱发育不良的成人脂肪瘤患者复发率较低。GTR（HR：0.172，95% CI：0.02557-0.7028）和病变长度（HR：1.351，95% CI：1.138-1.607）可独立预测复发/进展。对于无脊柱发育不良的成人脊柱脂肪瘤患者，可考虑保守手术治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.