[Clinical analysis of the adolescent patients with multi-segments intramedullary spinal cord tumors].
OBJECTIVE
To prospectively analyze the clinical features and characteristics of multi-segments intramedullary spinal cord tumors in adolescent  patients.


METHODS
In our study, 25 consecutive adolescent patients with multi-segments intramedullary spinal cord tumors were recruited, who  underwent microsurgery for the tumor using a posterior approach and were hospitalized in Peking University Third Hospital within a period of 8 years. The  tumor was exposed through dorsal myelotomy. Preoperative and postoperative neurological functions were scored using the improved Japanese  orthopaedic association score system (IJOA) grading system. The functional outcome was defined as postoperative IJOA score minus preoperative  IJOA score. All the patients were followed-up until Oct. 30, 2011.


RESULTS
There were 15 male and 10 female adolescent patients younger than 25  years. Their mean age was (15.3±6.83) years. The most common initial symptom was sensory disturbance (including pain and/or numbness, 52%, 13/25),  followed by motor disturbance (including limbs weakness and gait deterioration, 24%, 6/25), pain and motor disturbance (12%, 3/25), as well as fever, limbs  deformities, and sphincter dysfunction, respectively. The preoperative IJOA scores of the patients were (14.4±3.38). The postoperative IJOA scores of the  patients were (15.5±3.31). The most commonly involved location was the cervicothoracic segments (36%, 9/25), followed by the conus terminalis (24%,  6/25), the cervical region(16%, 4/25), the thoracic region (16%, 4/25), and the lumbus region (8%, 2/25). The average involved segments were (4.4±1.38).  The most frequent tumors were neurodevelopmental tumors (including lipoma, epidermoid cyst and teratoma) (32%, 8/25), followed by astrocytomas (28%,  7/25), ependymomas (20%, 5/25), hemangioblastomas (12%, 3/25), and glioblastomas and schwannomas, respectively.


CONCLUSIONS
In adolescent  patients with multi-segments intramedullary spinal cord tumors, the most commonly involved locations are the cervicothoracic segments and the conus  terminalis, while the most frequent tumors are neurodevelopmental tumors and astrocytomas. Good prognosis in adolescent patients is observed in a long-term follow-up.
Department of Neurosurgery, Peking University Third Hospital, Beijing, China.
Jian-jun
JJ
Sun
Zhen-yu
ZY
Sun
Zhen-dong
ZD
Li
Jing-cheng
JC
Xie
Xiao-dong
XD
Chen
Chang-cheng
CC
Ma
Bin
B
Liu
Jia
J
Zhang
Tao
T
Yu
Guo-zhong
GZ
Lin
D000293:Adolescent; D001254:Astrocytoma / Q000601:surgery*; D002574:Cervical Vertebrae; D004806:Ependymoma / Q000601:surgery; D005260:Female; D006801:Humans; D008067:Lipoma / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae; D055815:Young Adult