Yasui T, Hakuba A, Katsuyama J, Nishimura S
Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
Acta Neurochir Suppl (Wien). 1988;43:9-12. doi: 10.1007/978-3-7091-8978-8_2.
The management of patients with intramedullary spinal cord tumours is controversial. The authors have treated these tumours in accordance with the principles of radical resection, using microsurgical techniques. There have been 22 cases of intramedullary spinal cord tumours (4 astrocytomas, 3 glioblastoma multiformes, 5 ependymomas, 7 haemangioblastomas, 1 dermoid, 1 lipoma and 1 schwannoma) thus treated at our department during the past 13 years. Sixteen were adults and six were children. The early and late results of their surgical treatment have been analyzed, with follow-up periods ranging from 10 months to 12 years. Of the 22 patients, total removal was performed in 16, subtotal removal in 5 and biopsy in 1. Guidetti's criteria were adopted in assessing the results of surgery. Long-term results were as follows: 8 very good, 5 good, 3 fair, 3 poor and 3 deceased. The 3 latter cases were glioblastoma multiformes. Gross total removal of intramedullary tumours is technically feasible and compatible with neurological recovery. Since the majority of intramedullary tumours are benign and their course may span not only years but decades, long-term follow-up is essential.
脊髓髓内肿瘤患者的治疗存在争议。作者按照根治性切除原则，采用显微外科技术治疗这些肿瘤。在过去13年中，我科共治疗了22例脊髓髓内肿瘤患者（4例星形细胞瘤、3例多形性胶质母细胞瘤、5例室管膜瘤、7例血管母细胞瘤、1例皮样囊肿、1例脂肪瘤和1例神经鞘瘤）。其中16例为成人，6例为儿童。分析了他们手术治疗的早期和晚期结果，随访时间为10个月至12年。22例患者中，16例行全切除，5例行次全切除，1例行活检。采用Guidetti标准评估手术结果。长期结果如下：8例非常好，5例好，3例一般，3例差，3例死亡。后3例为多形性胶质母细胞瘤。脊髓髓内肿瘤的全切除在技术上是可行的，并且与神经功能恢复相容。由于大多数脊髓髓内肿瘤是良性的，其病程不仅可能持续数年，而且可能长达数十年，因此长期随访至关重要。
