神经电生理监测和超声技术在脊髓髓内肿瘤显微手术中的应用

Application of intraoperative neuroelectrophysiological monitoring and ultrasonography in microsurgery for intramedullary spinal tumor

目的探讨神经电生理监测及超声技术在脊髓髓内肿瘤显微切除术中的应用价值。方法回顾性分析10例脊髓髓内肿瘤病人的临床资料。均行肿瘤显微切除术,术中以体感诱发电位、自发肌电图监测和超声定位辅助肿瘤切除。结果肿瘤全切除8例,大部分切除2例。术后病理诊断:室管膜瘤6例,星形细胞瘤1例,少枝胶质细胞瘤1例,神经鞘瘤1例,蛛网膜囊肿1例。出院时神经功能改善或稳定9例,加重1例;无死亡病例。结论显微手术是治疗脊髓髓内肿瘤的有效措施,术中辅助神经电生理监测及超声技术可提高肿瘤切除率,最大程度保护神经功能,改善病人预后。

Objective To investigate the applied value of intraoperative neuroelectrophysiological monitoring and ultrasonagraphy on microsurgery for intramedullary spinal tumor.Methods Clinical data of 10 patients with intramedullary spinal tumor were analyzed retrospectively.All the patients were treated by microsurgery assisted with somatosensory evoked potential,electromyographic monitoring and ultrasound localization.Results Total tumor resection was achieved in 8 patients,and partial removal in 2.The tumors were diagnosed by postoperative pathological analysis including 6 ependymomas,1 astrocytoma,1 oligodendroglioma,1 neurilemmoma,1 arachnoid cyst.The neurological function was improved or maintained stable in 9 cases,aggravated in 1.No patients died.Conclusions Microsurgical treatment was effective for intramedullary spinal tumor.The applications of intraoperative neuroelectrophysiological monitoring and ultrasonography can increase removal rate,protect neurological function to the greatest degree,and improve the prognosis of the patients.