术中超声在椎管内转移瘤手术中的应用

目的 探讨术中超声在椎管内转移瘤显微手术中的应用效果。方法 回顾性分析2016年1月至2021年12月术中超声辅助显微手术治疗的18例椎管内转移瘤的临床资料。结果 4例部分切除进行活检，10例次全切除使脊髓充分减压，4例全切除。术中均去除椎板并扩大减压，未行椎体固定。术后无脑脊液漏、伤口感染。术后病理示肺癌4例，乳腺癌3例，淋巴瘤3例，胶质瘤3例，生殖细胞肿瘤2例，骨髓瘤2例，前列腺癌1例。10例术后症状明显缓解，8例无明显变化。2例术后6个月死亡。结论术中超声有利于椎管内转移瘤的定位，评估手术切除程度和减压效果，减少脊髓及神经损伤，提高治疗效果。

Application of intraoperative ultrasonography to micro-surgical removal of intraspinal metastatic tumors

Objective To investigate the application value of intraoperative ultrasonography in microsurgery for intraspinal metastases. Methods The clinical data of 18 patients with intraspinal metastatic tumors undergoing ultrasound-assisted microsurgery from January 2016 to December 2021 were retrospectively analyzed. Results Biopsy was performed in 4 patients with partial resection of the tumor, sufficient decompression of the spinal cord in 10 patients with subtotal resection of the tumor, and total resection of the tumor in 4 patients. The laminae were removed and decompression was expanded, and no vertebral body fixation was performed in all patients. There were no cerebrospinal fluid leakage and wound infection after the operation. Postoperative pathology showed lung cancer in 4 patients,breast cancer in 3, lymphoma in 3, glioma in 3, germ cell tumor in 2, myeloma in 2, and prostate cancer in 1. Postoperative symptoms were significantly relieved in 10 patients and not significantly changed in 8 patients. Two patients died 6 months after the surgery. Conclusions Intraoperative ultrasound is helpful to locating intraspinal metastatic tumors, evaluating the degree of surgical resection of tumors and the effect of decompression, reducing spinal cord and nerve injury, and improving the treatment outcomes.