脊髓髓内肿瘤的显微手术治疗

目的:评估脊髓髓内肿瘤的手术疗效,了解影响预后的因素。方法:回顾分析42例显微手术治疗的髓内肿瘤患者的临床资料,颈髓28例,颈胸交界6例,胸髓5例,圆锥3例。结果:肿瘤全切30例,次全切8例,部分切除4例。无手术死亡。随访3~36个月,病情较术前改善者24例,稳定者13例,加重5例。术前神经功能障碍严重的患者,术后恢复差。3例星形细胞瘤患者术后8~16个月内死亡。结论:脊髓髓内肿瘤在显微镜下大多可手术全切或次全切,并保留正常的脊髓功能,改善或稳定病情。手术应在神经功能加重前进行。恶性胶质瘤的手术效果及预后仍不满意。

Microsurgery of intramedullary spinal cord tumor

Objective:To evaluate surgical results and prognosis of intramedullary spinal cord tumors.Method: 42 patients underwent operation were analyzed retrospectively.The location of tumor was as follows,cervical in 28 cases,cervicothoracic in 6 cases,thoracic in 5 cases,and conus in 3 cases.Result:Total tumor resection was achieved in 30 patients,subtotal in 8,and partial in 4 patients.There were no operative death.When comparing the preoperative neurological function at follow-up period,24 cases improved,13 cases unchanged,5 cases deteriorated.Patients with preoperative severe neurological deficits had a poor surgical result.3 cases with astrocytoma died in 8~16 moths after operation.Conclusion:Total or subtotal resection in majority of spinal cord tumors could be obtained with good result.Surgery should be performed before significant disability occurs.Malignant tumors had a poor prognosis.