多模式神经电生理监测辅助显微手术治疗椎管内肿瘤的疗效分析

Clinical effect of microsurgery under multimodal neurophysiological monitoring in treatment of patients with intraspinal tumors

摘要:

目的 探讨多模式神经电生理检测下显微手术切除椎管内肿瘤的临床疗效。方法 回顾性分析2011年5月至2016年6月显微手术切除的椎管内肿瘤57例，术中采用体感诱发电位（SEP）、运动诱发电位（MEP）及肌电图（EMG）多模式神经电生理监测（MIOM）。结果 肿瘤全切49例（86.0%），次全切除6例（10.5%），部分切除2例（3.5%），失访4例，53例术后随访3个月~2年，神经功能改善45例（78.9%），无明显改善4例（12.3%），症状加重3例（7.0%），复发1例（1.8%）。结论 多模式神经电生理检测辅助显微手术切除椎管内肿瘤，能有效提高肿瘤全切率，并预测和保护脊髓神经功能，提高手术疗效及安全性。

Abstract:

Objective To investigate the clinical effect of microsurgical resection of intraspinal tumors under multimodal neurophysiological monitoring.Methods A retrospective analysis was performed for the clinical data of 57 patients with intraspinal tumors who underwent microsurgical resection of intraspinal tumors under multimodal intraoperative monitoring of somatosensory evoked potential (SEP),motor evoked potential (MEP),and electromyography (EMG).Results Of all patients,49(86.0%) underwent total resection,6(10.5%) underwent subtotal resection,and 2(3.5%) underwent partial resection.Four patients were lost to follow-up,and the other 53 patients were followed up for 3 months to 2 years after surgery,among whom 45(78.9%) achieved improvement in neurological function,4(12.3%) had no significant improvement,3(7.0%) had aggravated symptoms,and 1(1.8%) experienced recurrence.Conclusions Microsurgical resection of intraspinal tumors under multimodal neurophysiological monitoring can effectively improve the total resection rate of tumors,predict and protect the function of spinal nerves,and improve surgical outcome and safety.