Fischer G, Brotchi J
Hôpital Pierre Wertheimer, Lyon.
Neurochirurgie. 1994;40 Suppl 1:1-108.
Since Guidetti and Slooff's masterbooks (1964), numerous papers have been devoted to intramedullary spinal cord tumors (IMT) and their treatment, most of them were focused on ependymomas and astrocytomas. Informed opinion was that these tumors were difficult to cure and that biopsy plus radiotherapy was the treatment of choice. Thanks to microsurgery and bipolar coagulation surgeons grew bolder and more efficient as illustrated by the contributions from Hurth or Resche on hemangioblastomas, Fischer on ependymomas, Epstein on childhood astrocytomas and Guidetti, Malis, Stein on IMT in general. Meanwhile, in the eighties, Magnetic Resonance Imaging (MRI) and Cavitron Ultrasonic Surgical Aspirator (CUSA) drastically modified diagnostic and therapeutic strategies of IMTs, as may be judged by the significant increase in the number of publications on this topic in current medical literature. However, no updated work of synthesis is currently available. This prompted us to publish our common experience based on 171 patients and 200 surgical procedures. Thanks to the collaboration of many colleagues of the "Société de Neurochirurgie de Langue Française" (SNCLF) who completed a questionnaire sent to them, we are now in the position to give an epidemiological estimation based on 1117 cases. This work is divided in three main parts. The first part deals with considerations common to all IMTs, the second with particular aspects specific of each tumoral type, the third with the results and concluding recommendations.
自圭迪蒂和斯洛夫的权威著作（1964年）以来，已有大量论文致力于研究脊髓髓内肿瘤（IMT）及其治疗方法，其中大多数聚焦于室管膜瘤和星形细胞瘤。当时的普遍观点是，这些肿瘤难以治愈，活检加放疗是首选治疗方法。得益于显微外科手术和双极电凝技术，外科医生变得更加大胆且高效，赫特或雷舍对血管母细胞瘤的贡献、菲舍尔对室管膜瘤的贡献、爱泼斯坦对儿童星形细胞瘤的贡献以及圭迪蒂、马利斯、斯坦对一般脊髓髓内肿瘤的贡献都说明了这一点。与此同时，在20世纪80年代，磁共振成像（MRI）和超声手术吸引器（CUSA）极大地改变了脊髓髓内肿瘤的诊断和治疗策略，从当前医学文献中关于该主题的出版物数量显著增加就可以判断出来。然而，目前尚无最新的综合性著作。这促使我们发表基于171例患者和200次手术的共同经验。多亏了“法国神经外科学会”（SNCLF）的许多同事的合作，他们完成了发给他们的一份问卷，我们现在能够基于1117例病例给出流行病学估计。这项工作分为三个主要部分。第一部分涉及所有脊髓髓内肿瘤共有的考量因素，第二部分涉及每种肿瘤类型的特定方面，第三部分涉及结果及结论性建议。
