CAJ | 학술논문

目的探讨高颈段髓内室管膜瘤的显微外科治疗.方法回顾性分析23例高颈段脊髓髓内室管膜瘤,均行显微外科切除,术中均采用联合体感诱发电位(SEP)和运动诱发电位(MEP)监测辅助肿瘤切除.结果手术全切除肿瘤17例,近全切或大部分切除5例,部分切除1例；全组无手术死亡；术后门诊或电话随访22例,随访3个月至6年,神经功能改善16例(73％),稳定无变化4例(18％),加重2例(9％),随访期间无复发；术中诱发电位结果:真阴性18例( 18/19),假阴性1例,真阳性2例( 2/3).结论尽早显微手术切除是高颈段脊髓髓内室管膜瘤的有效治疗措施,术中联合SEP和MEP监测可提高肿瘤全切率,减少术后并发症,最大程度地稳定和改善神经功能.
목적 탐토고경단수내실관막류적현미외과치료.방법 회고성분석23례고경단척수수내실관막류,균행현미외과절제,술중균채용연합체감유발전위(SEP)화운동유발전위(MEP)감측보조종류절제.결과 수술전절제종류17례,근전절혹대부분절제5례,부분절제1례；전조무수술사망；술후문진혹전화수방22례,수방3개월지6년,신경공능개선16례(73％),은정무변화4례(18％),가중2례(9％),수방기간무복발；술중유발전위결과:진음성18례( 18/19),가음성1례,진양성2례( 2/3).결론 진조현미수술절제시고경단척수수내실관막류적유효치료조시,술중연합SEP화MEP감측가제고종류전절솔,감소술후병발증,최대정도지은정화개선신경공능.
Objective To investigate the microneurosurgcial management for intramedullary spinal ependymomas in the superior cervical spinal cord.Methods Clinical data of 23 patients with intramedullary ependymoma in the superior cervical spinal cord were analyzed retrospectively.All the patients were treated by microsurgery assisted with somatosensory evoked potential (SEP) and motor evoked potential (MEP).Results Total removal was achieved in 17 cases,subtotal removal in 5 cases and partial resection in 1 case.No patients died.A follow up of 3 months to 6 years by out - patient review and telephone interview were performed in 22 cases:neurological function was improved in 16 cases(73％ ),no changes occurred in 4( 18％ ),deteriorated in 2 (9％)and none was recurrence.Results of introperative monitoring:18 patients presented true negative findings,while 2 patient presented true positive findings,1 false positive findings.Conclusions Early microsurgical treatment is the most effective measure for intramedullary ependymoma in the superior cervical spinal cord.The combined applications of intraoperative SEP and MEP monitoring can increase removal rate,reduce postoperative complication,and improve the prognosis of the patients.