脊髓髓内室管膜瘤的外科治疗

Microsurosurgery of intramedullary spinal cord ependymomas

目的研究脊髓髓内室管膜瘤的显微外科手术技术。方法本文回顾分析了手术治疗318例脊髓髓内室管膜瘤的临床资料。结果全切除肿瘤311例,近全切除7例。随访129例,其中痊愈65例,症状明显减轻46例,症状无变化9例,症状加重7例,术后复发2例。无手术死亡。结论应用显微技术可以全切大多数髓内室管膜瘤。椎板成形术可提高术后脊柱稳定性,全切或近全切患者术后不需放疗。

Objective To investigate the microneurosurgery techniques in the treatment of intramedullary spinal cord ependymomas. Methods The clinical data of 318 patients with intramedullary spinal cord ependymomas were retrospectively reviewed. Results Total resection of the tumor was achieved in 311 cases, and subtotal removal of tumor in 7 cases. Totally 129 patients received follow-up, among them 65 patients were cured. The neurological symptoms were apparently improved in 46 patients, unchanged in 9 patients, and deteriorated in 7 patients. No perioperative death occurred. Conclusion The radical surgical resection of intramedullary ependymomas can be performed in most patients using microsurgical techniques. The laminoplasty can improve the stability of the spinal column. Patients who undergo total or nearlytotal resection need no radiation therapy.