Bhatti Sajid Nazir, Khan Shahbaz Ali, Raja Riaz A, Shah Rizwan, Aurangzeb Ahsan, Khan Abdul Aziz, Alvi Nazir, Pasha Muhammad Tousif
Department of Neurosurgery, Ayub Teaching Hospital Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Jul-Sep;22(3):15-7.
Intramedullary spinal cord tumours (IMSCT) are among the uncommon lesions at spinal cord. They can present with a vast array of symptoms and cause severe neurological deficits. With advent and frequent use of MRI more and more patients with IMSCT are picked up. By using modern microsurgical techniques better surgical outcome is achieved. The Objective was to analyse the surgical outcome of the patients with intramedullary Spinal Tumour operated at Ayub Teaching Hospital (ATH). Abbottabad.
Eighteen patients with IMSCT who presented at Neurosurgery Unit. ATH. Abbottabad during 2000-2010 were included in this study. Patients were diagnosed on the basis of MRI. They were operated using standard microsurgical techniques. Patients were followed up for a mean duration of 18 months after surgery and their preoperative and postoperative neurological status was analysed.
Patients with age group ranging from 15-50 (37.72 +/- 8.94) years with IMSCT were operated. Sixty-one percent of the patients were male and 39% were female. The region most commonly affected was cervical (44%) followed by conus medullaris (33%), cervicothoracic and thoracic each had frequency of 11%. Gross total removal (> 95%) was possible in 72% of cases while in rest of 28% cases resection of 80-95% was possible. Histologically 38.9% of the lesions were ependymomas, 27.8% were astrocytomas and 22.2% were teratomas. Neurofibromas and Primitive Neuroectodermal Tumours (PNET) each accounted for 5.5% of the cases. Overall postoperative neurology improved in 10 (55%) of patients, remained unchanged in 5 (27%) of cases, and deteriorated in 3 (16%) patients. One patient was lost in follow-up. Surgery on tumours in cervical and thoracic region carried a relatively poor outcome as compared to the lesion of conus. There were no deaths due to surgery.
Surgical removal of IMSCT is beneficial to patients with acceptable surgical risk. Better outcome is expected if the patients with good Frankel grade are diagnosed and operated early the course of disease.
脊髓髓内肿瘤（IMSCT）是脊髓少见病变之一。它们可表现出各种各样的症状并导致严重的神经功能缺损。随着MRI的出现及频繁应用，越来越多的IMSCT患者被发现。通过运用现代显微外科技术可取得更好的手术效果。目的是分析在阿伯塔巴德阿尤布教学医院（ATH）接受手术的脊髓髓内肿瘤患者的手术效果。
本研究纳入了2000年至2010年间在阿伯塔巴德ATH神经外科就诊的18例IMSCT患者。患者根据MRI进行诊断。采用标准显微外科技术进行手术。术后对患者进行平均18个月的随访，并分析其术前和术后的神经状态。
对年龄在15 - 50（37.72±8.94）岁的IMSCT患者进行了手术。61%的患者为男性，39%为女性。最常受累的部位是颈椎（44%），其次是圆锥（33%），颈胸段和胸段各占11%。72%的病例能够实现肿瘤全切除（>95%），其余28%的病例能够切除80 - 95%。组织学上，38.9%的病变为室管膜瘤，27.8%为星形细胞瘤，22.2%为畸胎瘤。神经纤维瘤和原始神经外胚层肿瘤（PNET）各占病例的5.5%。总体而言，10例（55%）患者术后神经功能改善，5例（27%）患者保持不变，3例（16%）患者病情恶化。1例患者失访。与圆锥病变相比，颈椎和胸椎区域肿瘤的手术效果相对较差。无手术死亡病例。
对于手术风险可接受的IMSCT患者，手术切除是有益的。如果Frankel分级良好的患者在疾病早期被诊断并接受手术，有望获得更好的效果。
