Characterization and Treatment of Spinal Tumors.
Characterization and Treatment of Spinal Tumors.
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DOI：
10.1007/s44231-022-00014-3
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发表时间：
2022-12-01
期刊：
影响因子：
--
通讯作者：
Lucke-Wold, Brandon
中科院分区：
文献类型：
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作者：
Amadasu, Efosa;Panther, Eric;Lucke-Wold, Brandon
与脑肿瘤相比，脊髓肿瘤的患病率是罕见的，脑肿瘤包括大多数中枢神经系统肿瘤。脊柱肿瘤可分为原发性肿瘤和转移性肿瘤，后者是最常见的表现。原发性肿瘤根据其在脊柱和脊髓中的位置细分为髓内肿瘤、硬膜内肿瘤和髓外肿瘤。背痛是脊柱癌患者的常见表现；然而，其他神经根性疼痛也可能存在。磁共振成像（MRI）是硬膜内、髓外和髓内肿瘤的首选成像方式。x线平片用于原发性骨肿瘤的初步诊断，而计算机断层扫描（CT）和MRI可能经常需要进一步的表征。完全手术切除是脊柱肿瘤的治疗选择，对于界限明确的病变可能是治愈的。然而，对于那些因切除大面积神经结构损伤而发病率增加的患者，可以建议病灶内切除同时进行辅助放疗和化疗。即使采用目前的治疗方案，侵袭性脊柱癌的预后仍然很差。包括分子靶向、免疫治疗和干细胞治疗在内的新治疗方法的进展，为更好地控制脊柱恶性和转移性肿瘤提供了潜力。
The prevalence of spinal tumors is rare in comparison to brain tumors which encompass most central nervous system tumors. Tumors of the spine can be divided into primary and metastatic tumors with the latter being the most common presentation. Primary tumors are subdivided based on their location on the spinal column and in the spinal cord into intramedullary, intradural extramedullary, and primary bone tumors. Back pain is a common presentation in spine cancer patients; however, other radicular pain may be present. Magnetic resonance imaging (MRI) is the imaging modality of choice for intradural extramedullary and intramedullary tumors. Plain radiographs are used in the initial diagnosis of primary bone tumors while Computed tomography (CT) and MRI may often be necessary for further characterization. Complete surgical resection is the treatment of choice for spinal tumors and may be curative for well circumscribed lesions. However, intralesional resection along with adjuvant radiation and chemotherapy can be indicated for patients that would experience increased morbidity from damage to nearby neurological structures caused by resection with wide margins. Even with the current treatment options, the prognosis for aggressive spinal cancer remains poor. Advances in novel treatments including molecular targeting, immunotherapy and stem cell therapy provide the potential for greater control of malignant and metastatic tumors of the spine.