CAJ | 학술논문

目的：探讨神经电生理监测在椎管内肿瘤患者显微手术中的应用。方法：回顾分析2012年5月-2014年10月20例行显微切除术椎管内肿瘤患者的临床资料，术中以体感诱发电位、运动诱发电位和肌电图辅助手术操作。结果：肿瘤全切12例，大部分切除8例。术后病理诊断：脊膜瘤4例，表皮样囊肿5例，神经鞘瘤4例，神经纤维瘤1例，脂肪瘤2例，星形细胞瘤2例（Ⅰ级1例，Ⅱ级1例），囊性畸胎瘤2例。术后通过门诊或电话进行随访，随访时间为3~12个月，患者神经功能稳定或改善18例，1例复发，1例加重，无死亡病例。结论：术中神经电生理监测可及时预警术者，减少手术对脊髓功能的干扰，有效保护脊髓神经，避免术后脊髓功能进一步下降，提高肿瘤全切率及安全性，改善患者预后。
목적：탐토신경전생리감측재추관내종류환자현미수술중적응용。방법：회고분석2012년5월-2014년10월20례행현미절제술추관내종류환자적림상자료，술중이체감유발전위、운동유발전위화기전도보조수술조작。결과：종류전절12례，대부분절제8례。술후병리진단：척막류4례，표피양낭종5례，신경초류4례，신경섬유류1례，지방류2례，성형세포류2례（Ⅰ급1례，Ⅱ급1례），낭성기태류2례。술후통과문진혹전화진행수방，수방시간위3~12개월，환자신경공능은정혹개선18례，1례복발，1례가중，무사망병례。결론：술중신경전생리감측가급시예경술자，감소수술대척수공능적간우，유효보호척수신경，피면술후척수공능진일보하강，제고종류전절솔급안전성，개선환자예후。
Objective:To discuss the application of intraoperative neurophysiological monitoring in the microsurgery made for intraspinal tumor patients.Method:The clinical data of 20 patients with instraspinal tumor from May 2012 to October 2014 were analyzed retrospectively. The data suggested that all of the 20 cases had adopted microscopic resection and the surgeries were assisted with somatosensory evoked potentials,motion evoked potential and electromyogram.Result:12 cases tumors were totally resected and 8 cases tumors were partially resected.Postoperative pathological analysis 4 spinal meningiomas,5 epidermoid cysts,4 neurilemmomas,1 neurofibroma,2 lipomas, 2 astrocytomas(1 grade Ⅰ astrocytoma and 1 grade Ⅱ astrocytoma),2 cystic teratomas.3-12 months follow-up by outpatient service and telephone back-visiting after the surgeries suggested that 18 patients’ neurological function had become stable or had been improved,1 recurred,1 exacerbated and no death case.Conclusion:Intraoperative neurophysiological monitoring can forewarn surgeons timely and reduce surgical interference to the spinal cord function, can protect spinal nerves effectively,avoid spinal cord function dropping after the surgeries, increase total removal rate and security and improve the patients’ prognosis.