ND-YAG LASER APPLICATION IN MICROSURGICAL TREATMENT OF INTRAMEDULLARY TUMORS

Abstract

Objective. To assess the efficacy of Nd-YAG laser application in microsurgical treatment of intramedullary tumors. Material and Methods. Eighty patients with intramedullary tumors were surgically treated. In 50 patients the tumor was resected using Nd-YAG laser under intraoperative spinal cord monitoring using somatosensory evoked potentials (SSEP), in 30 – it was removed by standard microsurgical techniques. Results of surgical treatment were assessed on the basis of findings of clinical neurological control, MRI, CT, and spinal cord sensory pathway intraoperative monitoring. Results. The study showed the advantages of laser over conventional methods of surgical treatment. Safe and effective application of Nd-YAG laser at final stages of intramedullary tumor resection, avoiding undesirable thermal effect on the spinal cord, suggests a power parameter to be set to 5–10 W. The action of laser irradiation in coagulation mode on an unremovable portion of the tumor under SSEP monitoring, apart from reduction of surgery traumaticity, provides increase in radicality of tumor removal, decrease in ongoing growth incidence, prolongation of recurrence-free period, and improvement of long-term postoperative quality of life. Conclusion. The obtained results permit to recommend the developed laser technology for further clinical application.