神经电生理监测在脊髓髓内肿瘤显微切除术中的应用

摘要

目的 探讨神经电生理监测在脊髓髓内肿瘤显微切除术的应用价值.方法 回顾性分析12例脊髓髓内肿瘤的临床资料.均行显微切除术,术中以体感诱发电位和肌电图监测辅助肿瘤切除.结果 肿瘤全切除8例,大部分切除1例,部分切除3例.术后病理诊断:室管膜瘤5例,星形细胞瘤5例,脂肪瘤1例,蛛网膜囊肿1例.随访6～17个月,神经功能障碍不同程度恢复11例,术后神经功能障碍1例.结论 显微手术是脊髓髓内肿瘤的有效治疗措施,术中辅以神经电生理监测可提高肿瘤切除率及手术安全性,最大程度保护神经功能,改善病人预后.%Objective To investigate the applied value of intraoperative neurophysiological monitoring in microsurgery for intramedullary spinal tumor.Methods Clinical data of 12 patients with intramedullary spinal tumor were analyzed retrospectively.All the patients were treated by microsurgery,assisted with somatosensory evoked potential and electromyographic monitoring.Results Total tumor resection was achieved in 8 cases,subtotal in 1,and partial removal in 3.The tumors were diagnosed by postoperative pathological analysis including ependymoma in 5 cases,astrocytoma in 5,lipoma in 1,and arachnoid cyst in 1.In 6-17 month follow-up,the neurological dysfunction was improved in 11 cases,aggravated in 1.Conclusions Microsurgical treatment is effective for intramedullary spinal tumor.The applications of intraoperative neuroelectrophysiological monitoring can increase removal rate and surgical safety,protect neurological function to the greatest degree,and improve the prognosis of the patients.