[Operative treatment of the intramedullary tumors with the methylprednisolone usage--preliminary report].
The aim of the study was to assess the intermediate results of the intramedullary tumors treatment with neuroprotection including the methyvlprednisolone (MP) usage.


METHODS
In the 1995-2003 period 33 patients with intramedullary tumors were operated on in Department of Neurosurgery in Sosnowiec. They were 10 females and 23 males in the age range of 11-61 years. Neuroprotection of the spinal cord in the course of treatment included: determining operational tactics on the basis of magnetic resonance imaging (MRI) performed in three planes, using MP according to NASCIS II and in maintenance dose in the 2-7 day after the operation, SSEP monitoring, myelotomy in the form of anatomical preparation of the posterior longitudinal fissure, sparing big transverse branches of the vasocorona of the posterior column, debulking of the tumor with an ultrasonic aspirator or CO2 laser, closure of the spinal cord after the removal of the tumor with pial sutures and sutures of the arachnoidea.


RESULTS
Among the operated tumors 16 had a clear border, the remaining ones were 14 astrocytomas of varying malignancy and infiltration of the white matter of the spinal cord and 3 lipomas. Control MRI revealed a total removal of the lesion in 23 patients (70%), gross total removal in 7 patients (21%) partial removal in three patients (9%). The postoperative condition of the patients 2-3 weeks after the operation showed improvement in 12 cases (37%), no significant changes in 10 cases (30%) and deterioration in 11 cases (33%).


CONCLUSIONS
Appropriate operative tactics together with the use of the MP make the acceptable morbidity rate after radical removal of intramedullary tumors .
Maliszewski
Mariusz
M
Z Katedry i Oddzialu Klinicznego Neurochirurgii w Sosnowcu Sl4skiej Akademii Medycznej, Katowicach. maliszewski_m@poczta.onet.pl
Majchrzak
Henryk
H
D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000401:mortality / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D018315:Glioma, Subependymal / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
D018696:Neuroprotective Agents; D008775:Methylprednisolone