Neuronavigation-Guided Corticospinal Tract Mapping in Brainstem Tumor Surgery: Better Preservation of Motor Function.
World Neurosurg
; 116: e291-e297, 2018 Aug.
Article
en En
| MEDLINE
| ID: mdl-29733992
ABSTRACT
OBJECTIVE:
To evaluate a new technique in brainstem surgery, neuronavigation (NN)-guided corticospinal tract (CST) mapping, in a retrospective study of patients undergoing brainstem tumor surgery.METHODS:
We studied 40 patients with a brainstem tumor who were enrolled in this study. Patients whose worst preoperative muscle strength of the 4 limbs was greater than 3 levels from normal on the Lovett scale were divided into 2 groups a treatment group of 21 patients who underwent NN-guided CST mapping and routine intraoperative neurophysiology monitoring (IONM) and a control group of 19 patients who underwent routine NN and IONM. Preoperative muscle strength and postoperative (day 90 postsurgery) muscle strength were assessed and compared between the 2 groups.RESULTS:
In the NN-guided CST mapping group, 3 patients (14.3%) had a decrease in muscle strength by 1 level postoperatively, and no patient experienced a decrease of >1 level. In the control group, 4 patients (21.1%) had a 1-level decrease in muscle strength, and 5 (26.3%) had a decrease of >1 level. Patients in the NN-guided CST mapping group had significantly better surgical outcomes compared with those in the control group (P = 0.018, Fisher exact test).CONCLUSIONS:
Brainstem tumor resection using NN-guided CST mapping achieved better preservation of motor function compared with routine NN and IONM. NN-guided CST mapping not only decreased the difficulty of the surgery, but also significantly improved the efficiency of surgery.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tractos Piramidales
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Mapeo Encefálico
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Neoplasias del Tronco Encefálico
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Neuronavegación
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Actividad Motora
Tipo de estudio:
Observational_studies
Límite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
China