Clinical Features And Microsurgical Treatment Of 32 Patients With Intramedullary Spinal Cord Cavernoma

Objective:To investigate the clinical features,surgical timing,surgical techniques and prognosis of intramedullary spinal cord cavernoma,and to summarize the experience in the treatment of intramedullary spinal cord cavernoma to guide its clinical application.Methods:Clinical data of 32 patients with intramedullary spinal cord cavernoma by pathological diagnosis after microsurgical treatment were collected from the department of neurosurgery of the first hospital of jilin university from January 2005 to December 2019.A retrospective analysis and summary were made.The preoperative,postoperative and long-term follow-up neurological function results were evaluated by McCormick's clinical neurological function grading method.Results:The average age of onset was 46.8±15.6 years.Male:female:1.46:1;The lesions were located in the cervical segment of 11 patients(34.4%),the thoracic segment of 19 patients(59.4%),and the lumbar segment of 2 patients(6.2%).The diameter of the lesion ranged from 0.5to 2.2cm,with an average of 1.2cm.Total resection was performed in 29cases,including 2 cases of near-total resection and 1 case of partial resection,with a total resection rate of 90.6%.Twenty-three patients(71.9%)received long-term follow-up(3-48 months),of which 16(69.6%)had improved neurological function,1(4.3%)had aggravation,and 6(26.1%)had no significant change in their condition.The clinical symptoms of 15 patients with McCormick grade I-II before surgery were significantly improved,and the clinical neurological function recovered rapidly.About 73.3%(11 patients)of the patients'neurological function tended to be normal,20%(3 patients)remained stable,and only 1 patient(6.7%)became worse.Of the 8 patients with grade III-IV,5(62.5%)showed some degree of improvement,but the recovery was slow,but all had some degree of neurological dysfunction,and 3(37.5%)had no remission.Preoperative McCormick grade I-II patients showed better therapeutic outcomes than grade III-IV patients(X~2=9.53,P<0.01).Conclusion:1.Most intramedullary spinal cord cavernoma can be treated safely and thoroughly by microsurgery and should be treated actively.2.Preoperative neurological functional status is closely related to the prognosis of patients,and patients with preoperative neurological functional status(McCormick grade I-II)can get a good prognosis.3.Reasonable choice of surgical timing and skilled microsurgical techniques can lead to better neurological outcomes.