简介：BACKGROUND&OBJECTIVE:Themajorityofintramedullaryspinalcordtumors(IMSCT)arelow-gradegliomas.RadicalresectionforIMSCTsremainschallenging.Recently,improvedneuroimagingandadvancedmicrosurgicaltechniquehavemadegreatsuccessinsurgicalmanagementoftheintramedullaryspinalcordtumors.METH-ODS&RESULTS:Twenty-ninepatientswithintramedullaryspinalcordtumorsweretreatedbyradicalresectiondur-ingthepast4yearsinourinstitute.Thehistologicalresultswereasfollows:12ependymomas,4astrocytomas,4heman-gioblastomas,4epidermoids,1cavernoma,2lipomas,2metastatics.Agross-totalresection(>95%)wasachievedin25surgicalprocedures.Subtotalresections(80-95%)wereperformedin4cases.Therewasnosurgicaldeath.Whencomparingthepreoperativeand3-monthpostoperativefunctionalgrades,12patientswerestable14improved,and3deteriorated.Patientswitheithernodeficitoronlymilddeficitbeforesurgerywererarelyimpairedbytheproce-dure,reinforcingtheimportanceofearlydiagnosisandtreatment.Themajordeterminantoflong-termsurvivalwashistologi-calcompositionofthetumor.PatientsinwhomanIMSCTwasonlypartiallyresected(<80%)faredsignificantlyworse.CONCLUSIONS:Thelong-termsurvivalandqualityoflifeforpatientswithlow-gradegliomastreatedbyradi-calresectionaloneiscomparableorsuperiortominimalresectionplusradiotherapy.Theoptimaltherapyforpatientswithhigh-gradegliomaisyettobedetermined.Forbenignlesion,suchashemangioblastomaandcavernomacouldbecuredbytotalresectionofthetumor.Forlipomaandepidermoid,fibrousadhesionstothecordmaketotalremovaldifficult,andthus,removalisnotthegoalofsurgery.Thecarbondioxidelaserisparticularlyusefulduringsurgeryforthislesion.