The Surgical Treatment Of42Cases Of Intramedullary Tumors

Objective:Through analyzing the data of42patients with intramedullary tumors who underwent microsurgical procedure, and following up their postoperative survival status, we aim to discuss the effect of microsurgery on patients’ survival status, further study of intraoperative neurophysiological monitoring in protecting the spinal cord function in surgical treatment for intramedullary tumors, and accumulate clinical experience of this technology in the treatment of of intramedullary tumors.Methods and Results:All together42patients from January2006to March2012in Peking Union Medical College Hospital were involved in the study, including7cases of astrocytomas,1pilocytic astrocytoma,5grade Ⅰ-Ⅱ grade astrocytomas,1grade Ⅲ,14cases of ependymoma,2grade Ⅰ,12grade Ⅱ,5hemangioblastomas,7Intramedullary epithelial cysts,2lipomas,3teratomas,3neurofibromatosis,1metastatic carcinoma. Through the medical records and telephone inquiries,we retrospectively analyzed the tumor types,locations,removal extents and long term outcomes. Ependymomas accounted for33.3%of all the intramedullary tumors with a total removal rate of85.7%,a subtotal removal rate of14.3%,and no biopsy was adopted. Astrocytoma accounted for16.7%of all cases, with a total removal rate of14.3%,a subtotal removal rate of14.3%,and a partial removal or biopsy rate of71.4%,Hemangioblastoma accounted for11.9%with a total removal rate of100%, epidermoid cyst accounted for16.7%with a total removal rate of28.6%,subtotal removal rate of71.4%,others accounted for21.4%with a total removal rate of33.3%,subtotal removal rate of66.7%.All patients were followed up for an average of36.5months,40patients were alive and2died.Conclusion:Intramedullary spinal cord tumors are more commonly benign or low grade tumors, and it indicated intraoperative neurophysiological monitoring helps protect the spinal cord function.