颈脊髓脊膜膨出九例临床分析  

Cervical myelomeningocele： a clinical analysis of 9 cases

作　　者：黄省利[1] 师蔚[1] 张立根[2] 

机构地区：[1]西安交通大学医学院第二附属医院神经外科,西安710004 [2]西安市儿童医院外科,710003

出　　处：《中华神经医学杂志》2010年第8期820-822,共3页Chinese Journal of Neuromedicine

摘　　要：目的 探讨颈脊髓脊膜膨出的临床表现、治疗方法 及要点. 方法 西安交通大学医学院第二附属医院和西安市儿童医院神经外科自2001年1月至2006年12月共收治9例颈脊髓脊膜膨出患者,其中1例左臂无力,8例神经功能正常.2例合并脑室稍大,1例合并脊髓纵裂,1例合并隐性骶裂.患者均行包块切除、椎管探查和（或）栓系松解术. 结果患者术后均无切口感染、脑脊液漏等并发症.随访术前神经功能正常的患者,术后未见神经症状出现.术前左臂无力患者术后恢复正常.2例合并脑室稍大的患者术后恢复正常. 结论 颈脊髓脊膜膨出临床表现特殊,MRI能显示病变的细微结构和其他脊柱畸形,治疗措施是早期手术,行病灶切除和（或）栓系松解,预后良好.Objective To investigate the diagnosis, and the treatment methods and techniques of cervical myelomeningocele. Methods Nine patients with cervical myelomeningocele, including 5boys and 4 girls, were chosen and received treatment from January 2001 to December 2006. Their ages ranged from 9 d to 5 y. All patients underwent neurological and radiological examinations. One of the 9patients had mild unilateral arm weakness and the others had neurological intact. Of these 9 patients, 4had other associated neurological or orthopedic abnormalities, including mild ventriculomegaly in 2,cervical diastematomyelia in 1 and sacral spina bifida occulta in 1. Surgical excision of the sac and intradural exploration of the sac were performed to release any potential adhesion bands. Results No complications, including cerebrospinal fluid leakage or infection were found after operation. During the follow-up of 1-7y （mean 3.9 y）, no cases suffered from any aggravation of the nervous symptoms. Nopatients with neurological intact had a noted neurologic deficit. One patient with left arm weakness got improvement following surgery and 2 with mild ventriculomegaly had normal cerebral ventricle.Conclusion Cervical myelomeningocele with clinical characteristics is a less common congenital spinal anomaly. MRI can identify the internal structures and associated anomalies. The management strategies of cervical myelomeningocele are early surgical treatment with standard microneurosurgicaltechniques to prevent the development of neurological defect. It is a safe and effective method to select and adopt surgery excision of lesions with intradural exploration of the sac to release any potential adhesion bands.

关 键 词：神经外科手术 颈脊髓脊膜膨出 椎管探查 

分 类 号：R651.2[医药卫生—外科学]