Kumar Ashish, Deopujari Chandrashekhar E, Karmarkar Vikram S
Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.
Asian J Neurosurg. 2012 Jan;7(1):32-5. doi: 10.4103/1793-5482.95695.
Intramedullary tumors constitute 2-4% of all the tumors affecting the central nervous system. They include low-grade astrocytomas and ependymomas in majority. Earlier, only biopsy or decompression used to be the best available options for these tumors, but with the upcoming technology and newer techniques, gross total excision with the aim of achieving complete removal has been the preferred treatment for these tumors. Usually, nearly all intramedullary tumors are approached from posterior midline myelotomy as this is the safest corridor to approach under neurophysiologic monitoring. But sometimes, if the tumor is exophytic, eccentric, or ventral to the cord, other routes of access may also be useful. These approaches are less frequently used these days and actually may be found useful in certain cases. Hence, they should not be termed "obsolete" and must be kept in mind for tumors in specific location. We describe a similar less commonly used dorsal root entry zone approach for near total excision of ventral and eccentric cervical pilocytic astrocytomas in two patients.
髓内肿瘤占所有影响中枢神经系统肿瘤的2% - 4%。其中大多数为低级别星形细胞瘤和室管膜瘤。早些时候，对于这些肿瘤，活检或减压是仅有的最佳可用选择，但随着技术的发展和新技术的出现，旨在实现完全切除的肿瘤全切除已成为这些肿瘤的首选治疗方法。通常，几乎所有髓内肿瘤都通过后正中脊髓切开术进行处理，因为这是在神经生理监测下进行手术的最安全通道。但有时，如果肿瘤是外生性、偏心性的，或者位于脊髓腹侧，其他入路也可能有用。如今这些入路较少使用，但在某些情况下实际上可能会发现其有用性。因此，不应将它们称为“过时的”，对于特定部位的肿瘤必须牢记这些入路。我们描述了一种类似的较少使用的背根入区入路，用于两名患者的腹侧和偏心性颈髓毛细胞型星形细胞瘤的近全切除。
