显微外科手术治疗脊髓髓内肿瘤21例分析

Microsurgical treatment for intramedullary tumors of spinal cord( report of 21 cases)

目的探讨显微神经外科手术切除脊髓髓内肿瘤的方法、技巧和疗效。方法回顾分析经显微外科手术治疗的21例脊髓髓内肿瘤患者的临床资料。7例部分切除,14例镜下全切除,术中有20例应用术中神经电生理监测。结果病理类型为室管膜瘤11例,星形细胞瘤7例,畸胎瘤、血管网状细胞瘤多发性原始神经外胚叶肿瘤各1例。患者平均随访时间42.8个月,随访期内1例肿瘤复发并死亡。术后神经功能障碍情况:16例较术前不同程度缓解,3例无变化,1例加重。结论术中针对不同肿瘤采用不同手术策略和技巧、应用术中神经电生理监测是保证疗效、减少并发症的关键。

Objective To investigate the methods, technique and curative effects of microsurgery for intramedullary tumors of spinal cord. Methods The clinical data of 21 patients with intramedullary tumor of spinal cord were analyzed retrospectively. Total resection of tumors were achieved in 14 patients and partial resection in 7. 20 patients had intraoperative neurophysiology monitoring（ IONM）. Results The pathologic tapes showed 11 cases were ependymomas,7astrocytomas,1 angioreticuloma,1 teratoma and 1 multiple intraspinal and intracranial primitive neuroectodermal tumor. All patients were followed up for average 42. 8 months,1 recurred and died.The preoperative clinical symptoms were relieved to some extents in 16 patients,unchanged in 3 and worsened in 1. Conclusion Application of various strategies and techniques for different tumor types and application of IONM are important for ensuring good outcomes and decreasing complications.