脊髄良性星細胞腫の手術経験

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The authors report their surgical experience in 3 cases of benign intramedullary spinal cord astrocytomas along with reviewing other cases reported in the literature. Gross total removal was achieved in all cases without severe disability. Case 1 is an adult case of fibrillary astrocytoma without postoperative radiotherapy and shows no tumor recurrence after a follow-up period of 15 years and 8 months. Case 2 is an adult case of gemistocytic astrocytoma, which recurred 1 year and 10 months later and was reoperated on 3 years and 3 months later with incomplete resection. The residual tumor disappeared after radiation therapy, but after the second surgery, the patient deteriorated neurologically in the upper extremities. However, there has no tumor recurrence at 3 years and 5 months after the second operation. Case 3 is a child case of fibrillary astrocytoma treated without radiation therapy and the patient's neurological status remains good without tumor recurrence after a follow-up period of 3 years and 2 months. The second and the third cases showed postoperative cervical spinal deformity requiring outer-immobilization for several months. Although, in our small series it is difficult to evaluate the usefulness of surgical treatment, we conclude that radical resection is the optimal therapeutic option and radical resection of benign intramedullary astrocytomas can be achieved with advanced microsurgical technique without significant problems. Radiation therapy should be employed for patients with incomplete resection. Care should be taken to prevent spinal deformity, especially in young patients.
日本脊髄外科学会の論文
1999-11-30

脊髄良性星細胞腫の手術経験

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