脊髓拴系综合征手术疗效分析  

Effect analysis of surgical treatment in tethered cord syndrome

作　　者：徐林[1] 洪毅[1] 易斌[1] 王波[1] 王昌海 周钧 

机构地区：[1]北京医科大学人民医院骨神经科,100034

出　　处：《中国脊柱脊髓杂志》1999年第6期304-307,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的：观察手术治疗脊髓拴系综合征（ＴＣＳ） 的术后功能改善情况。方法：对１１２ 例经ＭＲＩ明确诊断的脊髓拴系综合征的患者采用显微外科方法进行手术治疗。在神经电生理监测下进行硬膜外松解、切除脂肪瘤及纤维瘢痕，硬膜内松解粘连的神经根与脊髓，切断增粗的终丝。其中７２ 例得到２ 年以上随访。结果：手术年龄在１０ 岁以下者，术后感觉、运动、括约肌功能和并发症改善率达６０ ％ 以上，而年龄大于１０ 岁者却不足４０ ％ 。经Ｋｅｎｄａｌｌ 等级相关检验，手术年龄与术后功能改善呈正相关（ Ｐ＜ ０－０１） 。结论：ＭＲＩ是最可靠的诊断方法；诊断一经成立宜及早手术，手术年龄越小，术后效果越好；手术采用显微外科技术，并辅以神经电生理监测，可避免加重损伤。Objective:To observe the postoperative function improvement in patients with tethered cord syndrome.Method:112 patients with TCS defined by MRI were operated,and 72 of them were followed-up for at least two years.The patients underwent extradural release,lipomatomy,scar removal,intradural release of adhesive nerve root and spinal cord and transection of terminal filament.Result:After operation,more than 60 percent of patients who were younger than 10 years old improved in sensation,movement,sphincter function,and other complications.However,less than 40 percent of patients older than 10 years improved.Kendall grade correlation analysis shows positive relation between age of operation and function improvement (P<0 01).Conclusion:The most reliable diagnosis of TCS can be acquired from MRI.The operation should be performed as early as possible after confirmation of diagnosis.The younger,the better.To avoid injury,microsurgical technique and electrophysiological monitor should be applied.

关 键 词：神经松解术 脊髓拴系综合征 手术疗效 

分 类 号：R681.505[医药卫生—骨科学]