神经电生理监测辅助下显微手术治疗高颈段椎管内肿瘤

Effects of microsurgery under neurophysiological monitoring on the patients with upper cervical spinal canal tumors

目的 探讨神经电生理监测在显微手术治疗高颈段椎管内肿瘤中应用效果。方法 2011年3月至2014年3月收治高颈段椎管内肿瘤66例,均在神经电生理监测下行显微手术。结果 66例中,11例出现体感诱发电位监测异常,其中8例波幅下降20%-30%,3例波幅下降〉50%,均在30min后波幅恢复至20%以下;61例肿瘤全部切除,5例肿瘤部分切除;术后随访12个月,1例复发,1例再次手术。结论 在神经电生理监测下显微手术治疗高颈段椎管内肿瘤,可显著提高临床疗效。

Objective To investigate the curative effects of microsurgery under neurophysiological monitoring （NPM） on the patients with upper cervical spinal canal tumors. Methods The clinical data of 66 patients with upper cervical spinal canal tumors, who underwent microsurgery under NPM from March, 2011 to March, 2014, were analyzed retrospectively, including the operative outcomes, prognoses and so on. Results Of 66 patients, 11 had abnormal somatosensory evoked potential （SEP） including SEP amplitudes decreased by 20% to 30% in 8 patients and the amplitudes decreased by more than 50% in 3, and 55 normal SEP. The SEP amplitudes were returned to more than 80% of normal amplitudes in the patients undergoing abnormal SEP 30 min after the operation stopped. Total tumor resection was achieved in 61 patients and partial resection in 5. The operation was performed again in 1 patient with recurrent tumor during following-up for 12 months. Conclusion The microsurgery under NPM can significantly improve the prognoses in the patients with upper cervical spinal canal tumors.