Schultheiss R, Gullotta G
Neurochirurgische Universitätsklinik, Bonn, Federal Republic of Germany.
Acta Neurochir (Wien). 1993;122(1-2):91-6. doi: 10.1007/BF01446992.
In 42 patients with a spinal neurinoma or neurofibroma, resection of the affected nerve root was necessary in 24 cases for complete removal of the tumour. In 10 of these the resected nerve root was relevant for upper or lower limb function. Of this subgroup of 10 patients with a resection of a relevant motor root, only 4 showed an initial slight impairment of motor function, which was followed by complete recovery in two cases by the time of discharge from hospital. A persisting relevant motor impairment was not observed in any case. Recommendations given in the literature for the resection of spinal neurinomas vary from radical resection to strict microsurgical resection with preservation of as much of the nerve root as possible. This report together with the publication of Kim et al. suggests, that radical resection is possible without neurological deficit, if microsurgical preservation of unaffected nerve fibres is impossible or if the risk of recurrence is judged to be unduly high.
在42例患有脊髓神经鞘瘤或神经纤维瘤的患者中,24例为完全切除肿瘤需要切除受影响的神经根。其中10例切除的神经根与上肢或下肢功能相关。在这10例切除相关运动神经根的亚组患者中,只有4例最初出现轻微运动功能障碍,其中2例在出院时完全恢复。在任何情况下均未观察到持续的相关运动功能障碍。文献中关于脊髓神经鞘瘤切除术的建议各不相同,从根治性切除到尽可能保留神经根的严格显微手术切除。本报告与Kim等人的发表结果共同表明,如果无法进行未受影响神经纤维的显微保留,或者如果判断复发风险过高,则可以进行根治性切除而不出现神经功能缺损。