神经电生理监测下显微手术治疗脊髓髓内海绵状血管瘤

目的探讨神经电生理监测下显微手术治疗脊髓髓内海绵状血管瘤的效果。方法我院2008年10月至2012年10月收治经病理学证实的髓内海绵状血管瘤25例（男性12例,女性13例）;均在神经电生理监测下完成显微手术治疗,用Frankel分级评价手术疗效。结果术后随访时间为1～4年,平均2.3年。术前Frankel分级A级4例,B级1例,C级5例,D级8例,E级7例;术后1年Frankel分级A级3例,B级2例,C级3,D级7例,E级10例。术后症状改善18例（72%）,症状维持不变4例（16%）,症状加重3例（12%）。结论 MRI是术前诊断脊髓髓内海绵状血管瘤的最佳方式,手术是治疗脊髓髓内海绵状血管瘤的有效方法,术中联合神经电生理监测能够使手术更安全、更有效。

Microsurgery combined with neuroelectrophysiological monitoring for intramedullary spinal cord cavernous angiomas

Objective To investigate treatment of intramedullary spinal cord cavernous angiomas（IMSCCA） by microsurgery combined with neuroelectrophysiological monitoring and its curative effect on IMSCCA.Methods The clinical data of 25 patients with IMSCCA proved by pathological examination, of whom, 12 were male and 13 female, were analyzed retrospectively. The preoperative and postoperative MRI examinations were performed in all the patients, in whom microsurgery was performed under neuroelectrophysiological monitoring. The preoperative and postoperative neurological functions were assessed by Frankel grading.Results All the patients were followed up from 6 months to 5 years（mean, 2.3 years）. The clinical symptoms were improved in 18（72%, 18/25）, unchanged in 4（16%, 4/25） and worsened in 3（12%, 3/25） according to Frankel grading.Conclusions MRI is the best method to diagnose the IMSCCA before the surgery. The surgery is only a method to treat IMSCCA at present. The safety of microsurgery for IMSCCA and the curative effect of microsurgery on IMSCCA may be enhanced by neuroelectrophysiological monitoring.