211372 The classification and microsurgery of magnum foramen tumor

/Bian Liuguan(卞留贯，Dept Neurosurg，Ruijin Hosp，Shanghai Jiaotong Univ School Med，Shanghai 200025)…∥Chin J Neurosurg.-2011，27(1).-3～6

ObjectiveTo explore classification and surgical approach of magnum foramen tumor.MethodsA retrospective analysis was performed for 43 surgically treated patients with tumors involving foramen magnum.According to the site of tumor，the classification was divided into:Type Ⅰ，located at dorsal，Ⅰ a extra-medullary，Ⅰb intra-medullary，Ⅰ c intra-and extramedullary;TypeⅡ，located at ventral，Ⅱ a extramedullary，Ⅱ b intramedullary.The midline approach was used in the TypeⅠ (17cases)，while the lateral or far-lateral approach for the TypeⅡ (26 cases).ResultsTotal excision was performed in 35(81%).There were no mortality and no recurrence during the follow-up period.Thirty-two patients had improvement in their neurological status，3 cases unchanged.There were 8 cases aggravation，including newly cranial nerve deficits，hemiplegia，dyspnoea.ConclusionThe preoperative classification was useful for the selection of surgical approach and evaluation of surgical outcome.The midline approach was proper to TypeⅠ，while the lateral or far-lateral approach for the TypeⅡ.14 refs，1 fig.