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2ANALYSIS OF DIAGNOSTICS AND SELECTION OF SURGERY APPROACHES IN
VARIOUS SPINAL CORD TUMORS Husanov Z.T.
Husanov Zafar Tashmurodovich - Assistant of the Neurosurgery, DEPARTMENT OF NEUROSURGERY, SAMARKAND STATE MEDICAL UNIVERSITY, SAMARKAND, REPUBLIC OF UZBEKISTAN
Annotation: in this work, data of 85 patients with spinal cord tumors who were in the clinic of neurosurgery of the Samarkand State Medical Institute from 2010 to 2021 are analyzed. These results of the analysis show that when the first signs of spinal cord injury appear, these patients should be promptly referred to neurosurgical institutions and undergo MRI or MSCT.
Keywords: tumors, extramedullary, intramedullary, spinal, laminectomy, spine
Relevance. Spinal cord tumors account for about 10-15% of CNS tumors [1-4]. The ratio of the incidence of spinal cord and brain tumors ranges from 1:4 to 1:6 [5 -7]. Most often, spinal cord tumors are observed in a socaially active group of people aged 30-50 years, which determines the great relevance of this problem [8]. Tumors of the cervical spinal cord account for 19.0-36.5%, thoracic - 26.9-47.0%, lumbosacral - 23.0-33.3%, cauda equina and filament terminal - 11% [8 , 9]. Extramedullary tumors of the spinal cord are understood as neoplasms originating from the structures surrounding the spinal cord - roots, vessels, membranes, epidural tissue [3, 10-12]. The frequency of occurrence of extramedullary tumors is 1-1.3 cases per 100,000 population per year [13, 7]. Extramedullary tumors account for about 53-90% of all spinal cord neoplasms [4, 11, 13-15]. In turn, the frequency of intradural intramedullary tumors is 10-30% of the total number of spinal cord tumors [16-31].
Purpose of the study. The work is devoted to the modern diagnostic method and the choice of surgical approach depending on the length of spinal cord tumors.
Materials and research methods. In this paper, data of 85 patients with spinal cord tumors who were in the clinic of neurosurgery of the Samarkand Medical Institute from 2010 to 2020 are analyzed.
Results and discussions. For diagnosis, all patients underwent a thorough clinical and laboratory examination and modern X-ray, myelographic (MG) CT and MRI studies. Men accounted for 62.4% (51 patients), women -37.6% (34 patients). Children under 15 years old were 9.4%, patients from 16 to 62 years old were 90.6%. Extramedullary tumors occurred in 59.5% of patients, and intramedullary tumors in 40.5% of cases.
According to the level of localization of tumors, the thoracic region occupies the first place (48.1%), the cervicothoracic and thoracic-lumbar regions rank second (23.5%), the lumbosacral region ranks third (20.2%), and only in 8.2% of patients with tumors were located in the cervical spinal cord.
Tumors at the level of 1st and 2nd vertebrae occurred in 65.6% of patients, 3rd-4th vertebrae in 17.7%, 5th-6th vertebrae, i.e. long tumors in 5.1% and extra-long tumors (at the level of 6-7 or more vertebrae) in 11.93% (19) of patients (Fig. 2.).
It is noteworthy that in 3 patients superlong tumors of the spinal cord were located at the level of 11, 12 and 15 vertebrae (respectively, in 1 patient) and these patients also underwent surgery. All patients with long and extralong tumors underwent contrast MRI. Morphological studies showed that most of these patients had meningiomas, astrocytomas, ependymomas, and lipomas.
Conclusions. Thus, these data show that when the first signs of spinal cord injury appear, these patients should be promptly referred to neurosurgical institutions and undergo MRI or CT, and in their absence, contrast myelography with water-soluble pharmaceuticals. We use differentiated surgical approaches for different lengths of spinal cord tumors in order to minimize surgical trauma and maintain spinal stability.
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