Microsurgical treatment of intramedullary tumors

Objective To investigate the microsurgical treatment and efficacy of intramedullary spinal cord tumors. Methods The medical records of 17 patients with intramedullary tumors treated by microsurgery in neurosurgery Department of our hospital from June 2014 to June 2019 were retrospectively analyzed. Among the 17 patients, 13 patients had numbness of limbs as the first symptom, 9 patients had motor dysfunction of limbs, 2 patients had dysfunction of urine and stool, 2 patients had back pain and 1 had separation of pain and temperature. There were 1 case of dyspnea and 1 case of muscular atrophy. All patients underwent plain and enhanced MRI before operation to identify intramedullary space-occupying lesions. All cases were treated with reduction and fixation after total laminotomy. To summarize the postoperative pathology, preoperative and postoperative symptoms, signs and follow-up recurrence of the patients, and to evaluate the effect of surgical microsurgery in the treatment of intramedullary tumors. Results Eleven cases of ependymoma were totally resected in 10 cases and subtotally resected in 1 case. Two cases of astrocytoma were totally resected in 1 case and subtotally resected in 1 case. Epidermoid cyst, hemangioblastoma and glioblastoma were totally resected in 1 case and inflammatory tissue was partially resected in 1 case. Postoperative symptoms improved in 11 cases, including 1 case of preoperative lower limb paralysis and urinary incontinence, no change after operation, 5 cases of postoperative symptoms aggravated, 2 cases recovered completely after rehabilitation treatment, 2 cases had mild dysfunction, 1 case only slightly improved, left with moderate dysfunction, no death cases. Seventeen cases were followed up for 0.1-4.5 years, 2 cases had recurrence, 1 case had reoperation, and 1 case received radiotherapy. Conclusion Different microsurgery methods and surgical techniques are adopted for intramedullary tumors of different pathological and nature, and the success rate is higher. Those with severe preoperative symptoms have poor prognosis. Therefore, microsurgery is an effective and safe treatment for intraspinal tumors. Key words: Spinal cord tumors; Spinal canal; Microsurgery