颈髓肿瘤的手术治疗

Treatmentofcervicalspinalcordtumors.CheXi aoming,XuQiwu,BaoWeimin,etal.DepartmentofNeu rosurgery,HuashanHospital,ShanghaiMedicalUniversity,12WulumuqiZhongRoad,Shanghai(20ObjectiveToexplorethesurgicaltreatmentmethodsforcervicalspinalcordtumors.MethodsAco

目的探讨颈髓肿瘤的手术治疗问题。方法对１５６例颈髓肿瘤（髓内１００例，髓外５６例）行手术切除，根据肿瘤部位和类型，选择手术入路和处理方法。１１例使用运动诱发电位（ＭＥＰ）技术行术中运动功能监护。采用回顾性调查的方式，对治疗方法及手术疗效进行总结。结果１５６例颈髓肿瘤手术全切率８７２％（髓内８４０％，髓外９２８％），运动功能改善率８０８％（髓内７６０％，髓外８９３％）。结论颈髓肿瘤宜积极手术治疗。对不同部位和病理类型肿瘤的切除要遵循不同的原则和方法。

Objective To explore the surgical treatment methods for cervical spinal cord tumors. Methods According to their different sites and histopathological types, 156 cases of cervical spinal cord tumors (intramedullary 100 cases, extramedullary 56 cases) were surgically removedwith different approaches and methods. Of which operations the of 11 cass were monitored with motor evoked potentials(MEP) technique. By retrospective study, surgical methods and effect of those operations were summarized. Results Of all 156 patients, tumors were totally removed in 87.2%(intramedullary 84.0%, extramedullary 92.8%) and neurological atatus postoperatively improved were 80.8% (intramedullary 76.0%, extramedullary 89.3%). Conclusions Cervical spinal cord tumors should be treated with aggressive surgery. The principle and method of surgery varied according to the site and histopathological classification. Intraoperative monitoring with MEP was considered to be helpful to improve the surgical effect.