Microsurgically Resect The Intramedullary Spinal Cord Lesions By Neurophysiological Monitoring

Objective: Treatment of intramedullary lesions mainly rely on surgery, A retrospectiveanalysis of26cases of our department neurophysiological monitoring undermicrosurgical resection of intramedullary spinal cord lesions,to explore the protectiveeffect of neurophysiological monitoring in the surgery of intramedullary spinal cordlesions.Mehtods：To analyze26cases of microsurgical resection of intramedullary spinal cordlesions under neurophysiological monitoring from January2000to January2011, and tostudy the protective effect of neurophysiological monitoring on spinal cord and nerve inthe process of the surgeries.Results：The group of26cases of intramedullary lesions, no deaths in this group.Outpatient surgery or via telephone followed up from3months to24months.21casesof total resection and5cases of subtotal resection. Postoperative pathological diagnosisinclude4cases of inflammatory granuloma；7cases of glioma；13cases of Ependymaand2cases of cavernous hemangioma. Postoperative feeling of depth include11casesof feeling declining;15cases of feeling alleviating;7cases of muscle tension increasing;1case of lateral muscle tension decreasing;1case of urinating difficulty.24cases ofstability or improvement in spinal cord function;2cases worsening,1case of highcervical intramedullary tumor with breathing difficulties at postoperative, tracheotomyand ventilator support in postoperative, improved respiratory function in the patientafter one month,the patient recovered and discharged from hospital;1case of glioma, resection slightly larger intraoperative, intraoperative neurophysiological monitoringearly warned and stop the surgery, the patient with symptoms compared with thepreoperative worse. The group of26cases with no deaths. Stabilize or improve aftersurgery,24cases of aggravated two cases, Including one case of high cervicalintramedullary tumors huge tumor, difficulty breathing after tracheotomy ventilatorsupport, Postoperative respiratory function improved in1month, discharged.Conclusion：The best choice for inrtamedullary spinal cord lesions is radical microsurgicalresection.A positive attitude is critcal for intramedullary spinal cord tumors confirmedby MRI inspections,especially for those patients with neurological defects who cantolerate the operation.Neurophysiological monitoring in the microsurgical resection ofintramedullary spinal cord lesions,Monitoring the integrity of neurological functionvery well,timely reminder surgery, thus greatly reduces the complications caused byspinal cord and nerve damage,and predict postoperative nerve function.