脊椎裂合并腰骶脂肪瘤  

Lumbosacral Iipomas with spinal bifida

作　　者：蒋寿宁 姜观富[1] 程培俊[1] 董南海[1] 

机构地区：[1]上海市中西医结合医院神经外科,上海新华医院肌电图室

出　　处：《中华外科杂志》1994年第11期673-675,共3页Chinese Journal of Surgery

摘　　要：脊椎裂合并腰能脂肪屑，可在人体成长过程中对脊髓产生牵拉、压迫，引起双下肢感觉、运动异常和括约肌功能障碍。作者经治２５例，脂肪瘤大部切除后，修补硬脊膜缺损和椎旁肌裂孔。术后随访２～５９个月，平均３７．５个月。结果２例术前无神经症状者仍良好，余２３例中７ｓ％的病例恢复排便功能，６６．２％排尿功能恢复正常或好转。７８．３％双下肢运动和感觉好转，轻度尿毒症１例恢复正常，中度１例好转。４例褥疮痊愈。AbstractSpinal dysraphism is usually accompanied withlumbosacral lipoma.The neurological deficits such aslower extremities sensorimotor disturbances,boweland bladder dysfunction are produced by tethering,compression of lipoma and direct transmission of exter-nal force on the spinal cord during growth period.25patients treated surgically at our hospital betweenMay,1985,and January,1993,were reviewed.Sur-gical approach was designed for debulking the lipoma-tous mass,untethering and decompressing the cord,repairing the dural defect and paraspinal muscle cleft.2～59 months(mean 37.5 mons)after operation the 2patients whose neurological system were normal beforeoperation remained intac,In other 23 patients,bowelfunction recovered in 75%,active urhation restoredand improved in 66.2%. Motor dysfunction and pares-thesia of the lower extremities alleviated in 78.3%。Acase of mild uremia returned to normal and anothermoderate case improved.None was deteriorated by theoperative procedure except one case in which a posteri-or nerve root was injured.

关 键 词：脊柱裂 腰骶部 脂肪瘤 

分 类 号：R682.3[医药卫生—骨科学] R739.93[医药卫生—外科学]