神经电生理监测下显微手术切除脊髓髓内肿瘤

目的 探讨在神经电生理监测下显微手术切除脊髓髓内肿瘤的效果。方法 回顾性分析2009年12月至2015年2月收治的102例髓内肿瘤患者临床资料。采用后正中入路手术切除肿瘤，所有手术均在神经电生理监测下进行。结果 肿瘤全切52例（50.98%），大部分切除48例（47.06%），部分切除2例（1.96%）。术后2周神经功能障碍改善16例（15.69%），无变化20例（19.61%），加重66例（64.7%）。98例随访3个月~2年，神经功能较术前改善94例（92.16%），其中完全正常者67例（65.69%）；症状仍未恢复到术前4例（3.92%），肿瘤复发4例（3.92%）。结论 采用显微手术切除髓内肿瘤是治疗该病的有效方法，术中神经电生理监测有助于手术的安全进行。

Clinical value of intraoperative electrophysiological monitoring to microsurgery for intramedullary spinal tumors

Objective To explore the clinical effect of microsurgery under intraoperative electrophysiological monitoring on intramedullary spinal tumors (IMST). Methods The clinical data of 102 patients with IMST, who received the microsurgery through the posterior midline approach under the intraoperative electrophysiologic monitoring using somatosensory evoked potentials (SEP), motor evoked potentials (MEP) and electromyography (EMG) from December 2009 to February 2015 in our hospital, were analyzed retrospectively. Results The total resection of IMST was achieved in 52 patients (50.98%), subtotal in 48 (47.06%) and part in 2 (1.96%). The neurologic function was improved in 16 patients (15.69%), unchanged in 20 (19.61%) and worsened in 66 (64.71%) 2 weeks after the operation. Of 98 patients followed up from 3 to 24 months, 4 suffered from the recurred tumors, 67 (65.69%) returned to normal and 27 (26.47%) were improved in the symptoms. Conclusions Microsurgical resection is an effective method to treat IMST. Intraoperative electrophysiological monitoring is helpful to the decrease in the surgery-related injuries and postoperative complications in the patients with IMST.