骶部硬膜外囊肿的诊断和治疗  

Diagnosis and Treatment of Extradural Cysts at Sacra

作　　者：杨永林[1] 马文学[1] 

机构地区：[1]解放军第92医院骨科,福建南平353000

出　　处：《临床军医杂志》2005年第4期455-456,共2页Clinical Journal of Medical Officers

摘　　要：目的探讨骶部硬膜外囊肿临床表现和影像学的特点,以提高该病的诊断和治疗水平。方法回顾18例经手术证实的骶部硬膜外囊肿病例,分析患者的临床症状、体征、影像学表现和治疗方法。结果18例患者均有腰骶部疼痛,5例伴有下肢痛,其疼痛多发生在站起和坐下的过程中,与体位变化有明显关系,站立时疼痛加重,卧位时较轻,头低位时更轻,与腰椎间盘突出症临床表现不尽相同。MRI检查示骶椎管明显扩大,膨胀及椎体后缘被压表现。本组均手术治疗,同时行腰椎间盘髓核摘除术5例。结论MRI是诊断骶部硬膜外囊肿的可靠方法,影像学显示囊肿大且神经症状重者囊肿切除是有效的治疗方法。Objective To discuss the clinical manifestations and the imaging characteristics of extradural cysts at sacra, so as to improve their diagnosis and treatment. Methods The 18 cases of extradural cysts at sacra confirmed by operation were retrospectively analyzed on the aspects of clinical symptom, sign, imaging manifestation and treatment. Results All the 18 cases had pains in waists or at sacra, and five of them were accompanied by lower limb＇s pain. Their pains mainly occurred during the course of standing up and sitting down, and they had something to do obviously with the position, i.e. intense pain in stand position and moderate plan in horizontal position, which differed from lumbar intervertebral disc hernia to some extent. MRI indicated that the sacral canals enlarged and dilated and that the hind vertebral sides were pressed. All the 18 cases, five of which were performed with extraction of nucleus pulposus simultaneously, were effectively treated with operation. Conclusion MRI is a reliable way to the diagnosis of extradural cysts at sacra. It is effective that the large cysts with severe nervous symptoms are resected.

关 键 词：骶部 硬膜外囊肿 

分 类 号：R739.42[医药卫生—肿瘤]