神经电生理监测下椎管内肿瘤的显微外科治疗

目的 探讨神经电生理监测在椎管内肿瘤的显微外科治疗中的作用。方法 2013年5月至2015年5月显微手术治疗椎管内肿瘤49例，术中采用体感诱发电位（SEP）联合运动诱发电位（MEP）监测辅助。结果 术中诱发电位结果:真阳性26例（26/29），假阳性 3例；真阴性 17例（17/20），假阴性3例。肿瘤全切除34例，次全切除6例，部分切除9例；无手术死亡。术后41例随访6个月至2年，神经功能改善31例（75.6%），无变化4例（9.8%），加重6例（14.6%）；复发9例。结论 对于椎管内肿瘤的显微外科治疗，术中采用SEP和MEP联合监测，有助于提高肿瘤全切率，减少术后并发症，改善脊髓神经功能。

Microsurgery for intraspinal tumors under electrophy- siological monitoring

Objective To investigate the microsurgical treatment of intraspinal tumors under electrophysiological monitoring. Methods The Clinical data of 49 patients with intraspinal tumors, who were treated by microsurgery under somatosensory evoked potential (SEP) and motor evoked potential (MEP) monitorings, were analyzed retrospectively. Results The intraoperative electrophysiological monitoring showed that of 49 patients, 26 presented true positive findings, 3 false positive findings, 17 true negative findings and 3 false negative findings. The total removal of the tumors was achieved in 34 patients, subtotal in 6 and partial in 9.No patient died from the operation.Forty-one patients were followed up from 6 to 24 months. The neurological function was improved in 31 patients (75.6%), unchanged in 4(9.8%), deteriorated in 6(14.6%) and the tumors recurred in 9 patients during the following-up. Conclusions The introperative electrophysiological monitorings including intraoperative SEP and MEP monitorings is helpful to the increase in the total resection rate, decrease in the postoperative complications, and improvement of the prognoses in the patients with intraspinal tumors.