ABSTRACT
Objective: To explore the microsurgical treatment of spinal canal tumors and to analyze the strategies for clinical treatment of spinal canal tumors. Methods: Were retrospectively analyzed the clinical data of 145 patients with spinal canal tumors who were treated in our hospital from Dec. 2014 to Nov. 2016. Microscopic resection of tumors was performed with half lamina-, full lamina-, or lamina joint-fenestration. Spinal internal fixation was performed in 52 patients. The patients were followed up for 3-26 months. X-ray and magnetic resonance imaging were performed again in all patients, and computed tomographyed was performed in patients undergoing internal fixation. The spinal cord function was assessed by McCormick grade before operation, 1 week after operation and 3 months after operation. Results: Of the 145 patients, 127 underwent total resection, 16 underwent subtotal resection and 2 underwent partial resection. One patient with cervical intramedullary tumors developed kyphosis after operation and underwent reoperation. No screw rod dislocation or spine instability was found in the 52 patients undergoing spinal internal fixation. The McCormick grading was significantly better 1 week and 3 months after operation versus before operation (P<0.05). Conclusion: Microsurgery is an effective method for treatment of spinal canal tumors. Good intraoperative exposure and reliable spinal internal fixation are essential to reduce the complications after spinal canal tumor surgery.
ABSTRACT
Objective To probe into the pre-operative design and the operative approach dealing with anastomotic vein and superior sagittal sinus in patients with large meningiomas in the sagittal sinus and falx cerebri. Methods Thirty-five patients with large meningiomas in the sagittal sinus and falx cerebri, admitted to our hospital from January 2001 to December 2010, were chosen; their clinical data were analyzed retrospectively. The resection of the tumors by microsurgery (total or subtotal resection) was performed and intraoperative effective management of the sagittal sinus and falx cerebri was done. Results Resection was performed in these 35 patients, including Simpson grade Ⅰ in 21(60.0％), grade Ⅱ in 12 (34.2％), and grade Ⅲ in 2 (5.7％). Skull defect was noted in 5 patients. Unilateral paralysis of limbs (muscle strength grade Ⅰ-Ⅳ) in 5; paralysis of both lower extremities (muscle strength grade Ⅰ-Ⅱ) in 1; good results were achieved after 1-6 months of hyperbaric oxygen, acupuncture and physiotherapy. During the follow-up period for 6 to 24 months, the tumor recurred in 2 with Simpson Ⅲstage resection (5.7％). Conclusion Designing a detailed pre-operative design according to the MRI,MRA, DSA and CTA, application of microsurgical techniques, avoidance of damage to the cerebral cortex and veins of central suleus and protection of the sagittal sinus are important factors that increase the success rate of surgical resection, reduce complications, prevent the tumor recurrence and improve the survival outcome in patients with parasagittal meningiomas.