Clinical Characteristics And Surgical Treament Of The Cervical Intramedullary Spinal Cord Tumors

Object:To discuss the microsurgical treament of the cervical intramedullary spinal tumor and its prognosis.Methods:About 53 patients who underwent surgery between January 2006 and June2016 in our hospital are analysed retrospectively,including their epidemiological characters,clinical presentations,imaging features,histopathologic characteristics、surgical technique and surgical result.Patients are divided into 2 groups: using intraoperative neurophysiological monitoring(group A)and not using intraoperative neurophysiological monitoring(group B).The functional scale proposed by Mc Cormick was used to evaluate patients’ neurological status before surgery,at discharge and 6 months postoperitively.Compare the score of the two groups.Result:The mean age of patients was 36.7±3.2 years(range 22.1–45.7 years).The means of the Mc Cormick grade(MG)scores of group A before the operation,at discharge and 6 months after the operation were 2.30±0.72,2.0±0.82,1.79±0.73,respectively.The means of the Mc Cormick grade(MG)scores of group B before the operation,at discharge and 6 months after the operation were2.3±0.71,2.2±0.93,1.9±0.94,repectively.When they were discharged from hospital,22patients(66.7%)of group A improved,while 10 patients(50%)improved in group B,and they were not significantly different(Χ2=1.45,P=0.23>0.05).By 6 months postoperatively,28 patients(84.8%)of group A improved,while 12 patients(60%)improved in group B,and they were significantly diffrent(Χ2=4.15,P=0.042<0.05).The postoperative pathological results revealed that 26 were ependymoma(24 undergone gross-total resection,2 patients undergone subtotal resection),15 were astrocytoma(8 patients undergone gross total resection,4patients undergone subtotal resection and 3 patient undergone partial resection),6 were hemangioblastoma(gross total resection).3 were cavernoma(gross total resection),1 was lipomyoma(subtotal resection)and 2 were metastatic tumor(subtotal resection).Conclusion:Microsurgery is very effective therapeutic method in patients with the intramedullary cervical spinal tumor.Surgery outcome correlated significantly with preoperative statuses extent of tumor resection and histopathology.Favorable outcome may be achieved in patients with good preoperative statuses,greater extent of tumor resection and low histopathological grade.Intraoperative neurophysiological monitoring helps to resect the tumor completely and benifits the protection of neurological status,especially for the long time outcome.The operation of cervical intramedullary spinal tumor must be complemented by experienced and skilled neurosurgeon for its challenge.