脊髓栓系综合征的诊断与显微外科治疗  

Diagnosis and Microsurgical Treatment of Tethered Cord Syndrome(Report of 21 cases)

作　　者：沈书廷[1] 杨建玲[1] 牛忠平[1] 海燕[1] 

机构地区：[1]赤峰市医院神经外科,病案室,内蒙古赤峰024001

出　　处：《内蒙古医学杂志》2005年第1期16-18,共3页Inner Mongolia Medical Journal

摘　　要：目的 :探讨脊髓栓系综合征 (TCS)的临床特点、手术治疗及效果。方法 :回顾性分析我科自 1998年 9月～ 2 0 0 4年 1月收治的 2 1例病人。结果 :年龄最小 4个月 ,最大 5 0岁。显性脊柱裂 10例 ,其中 2例曾做过脊膜膨出修补术 ;隐性脊柱裂 9例 ,2例无脊柱裂。常见的症状为小便失禁、足内翻畸形、腰腿痛。 2 1例病人均有MRI检查结果 ,7例有椎管内占位性病变。 17例经历了显微外科松解术。随访 3个月～ 5年 ,平均 2年 ,好转 9例 ,无变化 8例 ,4例失访。结论 :有脊柱裂及典型症状者均应行MRI检查 ,尽早发现TCS 。Objective:To explore clinical features,surgical treatment and effectiveness in tethered cord syndrome.Methods:21 cases of tethered cord syndrome treated by microsurgery from 1998 to 2004 were retrospectively analyzed.Results:The age of patients ranged from 4 months to 50 years.Of a total of 21 cases,there were 10 bifida manifesta including 2 with secondary operation,9 spina bifida occulta and 2 no spinal bifida.Urinary incontinence,clubfoot,pain in lumbar and sacral region were common manifestations.MRI performed in 21 cases showed 7 interspinal tumors.17 cases underwent untethering microsurgery.The average duration of follow-up was 2 years (range,3 months to 5 years).9 of 21 cases weve improved and 8 of 21 were not improved after treatment.Conclusion:MRI should be done in patients with spinal bifida and typical presentations.It is importment that early diagnosis and complete untethering the spinal cord.

关 键 词：脊髓栓系 诊断 外科治疗 

分 类 号：R651.2[医药卫生—外科学] R442.8[医药卫生—临床医学]