馬尾神経鞘腫 : 神経根切断に際して術中電気刺激を用いた 3 例

概要

論文の詳細を見る
When surgically removing a spinal neurinoma, preservation of the involved root may be feasible. However, in many cases, sacrifice of the relevant root is required to achieve total tumor removal. Sacrifice of the posterior root has been reported as having a low risk of causing any disabling neurological deficit. However there is the possibility of severe neurological deficit after sacrificing the anterior root in the cervical or lumbosacral region is pointed out. Intraoperative bipolar stimulation (1Hz, 1-2mA, 200μsec, square wave) was applied to three patients with neurinoma of cauda equina to confirm whether relevant root is anterior or posterior. Stimulation of anterior root showed movement of the lower extremities, and that of posterior root did not show any movement. The neurinomas of all three patients arose from the posterior roots, and were totally removed by sacrificing the involved roots. Postoperatively no new neurological deficit was observed, and the preoperative neurological deficit improved within several months after operation. Intraoperative electiric stimulation may prove useful to determine the nerve roots involved by neurinomas, and to test whether they are motor or sensory roots. However, we should bear in mind that this method can be applied when the level of the involved root is S1. For roots below the levelof S2, monotoring of electromyography should be used.
日本脊髄外科学会の論文
2003-07-31