Clinical efficacy of microsurgical resection for patients with intramedullary spinal cord tumors(report of 35 cases)

YANG Rui-xin; LI Tian-dong; PENG Chong-qi; Zou Yu-hui; GONG Fang-he; ZHAN Yu-fei; WANG Guo-liang; BAI Hong-min

doi:10.13798/j.issn.1009-153X.2023.12.006

Abstract：Objective To investigate the surgical treatment of patients with intramedullary spinal cord tumors(ISCTs).Methods The clinical data of 35 patients with ISCTs who underwent mirosurgery from January 2008 to December 2016 were retrospectively analyzed.Results Total resection was performed in 25 patients(71.4％),partial resection in 8(22.9％)and biopsy in 2(5.7％).Postoperative pathological results showed ependymal tumors in 14 patients,gliomas in 9,hemangioblastoma in 2,epidermoid cyst in 3,metastatic tumors in 3,cavernous hemangiomas in 2,primary central nervous system lymphoma in 1,paraganglioma in 1,and cyst in 1.The total resection rate of ependymomas(78.6％)was significantly higher than that(33.3％)of gliomas(P＜0.05).Postoperative infection occurred in 1 patient(2.9％).There was no cerebrospinal fluid wound leakage,external fixation loosening or loss,or surgical deaths.Nineteen patients(54.3％)were classified as McCormick grade Ⅰ,8(22.8％)as grade Ⅱ,5(14.3％)as grade Ⅲ,and 3(8.6％)as gradeⅣ before peration.Six months after surgery,McCormick grade Ⅰ was achieved in 15 patients(42.9％),grade Ⅱ in 9(25.7％),grade Ⅲin 6(17.1％),and grade Ⅳ in 5(14.3％).There was no significant difference in McCormick grades before and after surgery(P＞0.05).Six months after surgery,McCormick grades were improved in 6 patients(2 ependymomas,1 cavernous hemangioma,1 gangliocytic gliomas,1 hemangioblastoma,and 1 metastatic adenocarcinoma),not significantly changed in 24,and worsened in 5 gliomas patients.Conclusions MRI is helpful to diagnose ISCTs early.When the patients with ISCTs undergoing microsurgery,the proper fixation method can not only obtain the effective resection of the tumors,but also maintain the stability of the spine.