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韓國人 脊髓腫瘍에 關한 硏究 Spinal Cord Tumors

최신의학 1967년 10권 6호 p.29 ~ 42
서영환,
소속 상세정보
서영환 (  ) 
서울대학교 의과대학 신경외과학교실

Abstract


Since the first successful removal of a spinal cord tumor by Victor Horsley in 1888, our knowledge of the pathology and diagnosis of this type of neoplasm and of its surgical treatment has been greatly enriched by meny workers throughout the world. The increasing number of reports of successful operations for spinal cord tumors clearly indicated the importance of early diagnosis and surgical treatment. Prolonged delay before treatment may lead to permanent paralysis and death of the patients, whereas, the early surgical removal of the tumor often results in complete restoration of normal function.
The purpose of this investigation is to analyze certain clnical and pathologic findings in a series of 120 Korean patients of spinal cord tumors. These cases were operated at the Seoul National University Hospital from September, 1957 to Narch, 1967. The study is concerned with neoplasms which originated in the spine or from the structures within the spinal canal and metastatic malignant tumors.
The types of tumors which were pathologically identified were neurofibroma, 38 cases (23. 4 per cent.); meningioma, 20 cases (16. 8 per cent.); tuberculoma, 8 cases (6.7 per cent.); gpoma, 5 cases (4.2 percent.); 4 cases (3.3 per cent.) each of paragonimiasis, malignant lymphoma and lymphosarcoma; 3 cases (2.5 per cent.) each of lipoma, angioma and osteogenic sarcoma; 2cases (1.7 per. cent.) each of
i multiple myeloma, chordoma and reticulum cell sarcoma; one case (0.8 per cent.) each of spinal lithiais, dermoid cyst, rhabdomyosarcoma, lymphoma, cysticercus and unclassified malignant tumor; and metastatic malignant tumor, 23 cases (19.3 per cent.) Sixty tumors (50 per cent.) occurred in the thoracic portion of the spine. Twenty-five tumors (20.8 per cent.) were found in the lumber region; twenty-two (18.4 per cent.) in the cervical region; seven (5.8 per cent.) in the sacral region; and six (5 per cent.) in the Iumbosacral region.
The horizontal locations of the tumors were as folllows: Intrameduliar´y, nine (7.5 per cent.); extrame dullary intradural, fifty-one cases (42.5 per cent); and extradural, sixty cases (50 per cent.)
The age of the majority of patients was between fourty and sixty years; the youngest patients was a fiveyear-old girl who had a intramedullary astrocytoma and the oldest was a man of seventy who had a exturadural metastatic tumor. The average age of the patient in the whole series of cases was 38.4 years.
In regard to the sex of the patients, there were more males (74 cases) than females (46 cases).
It is interesting to note that neurofibroma was 1.5 times more prevalent among males than among femaces rnen~ngiomn ~w ´"´"" e ore e alent among females than ~agagonun
f, c~sticercoSiS´happene ioq nes and dernioid,cyst and spinal´lithtasis on y, in females
~v+t[
~ A review of the sub}ective 4mplamts of all patients revealed that pain or dysesthesia in 98 cases Sul 7 Per cent.);´motor andlsensor=y~dlsturbance 6 115cases~.(95.8 per went:) apd disturbances of sphincter_;
´ control in 102 cases (85 per cent.) In the´ majority of cases a combination of two or more of th,, x
Symptoms had developed during the, evolution of the disease.
The color of , the cerebrospinal fluid obtained by lumbar puncture was recorded, in 64 ´cases; this w a, yellow in 49 cases and colorless in-15 cases. The total protein was incerased in 57 cases. The cell count of the fluid was normal in 51 cases (79: 7 per cent.). The Queckenstedt test was made in 64 cases; compl_ ´ etc block was demonstrated in 41 cases (64 per, cent.), partial block in 12 cases (18 8percent) and no block . in 11 cases (17.2 per, cent.).
It was apparent that the best results of surgical treatment were obtained in those cases in which the patients harbored benign slow-growing tumors such as neurofibroma ; or meningioma but the results´
of treatment for the intramedullary tumors and malignant metastatic tumors were uniformly poor

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