显微手术治疗脂肪瘤型脊髓栓系综合征的疗效分析（附611例报告）  

Effects of microsurgery for lipoma tethered cord syndrome： report of 611 cases

作　　者：崔志强[1] 修波[1] 孙振兴[1] 萧凯[1] 罗天宝[1] 段宏宇[1] 

机构地区：[1]清华大学玉泉医院脊髓脊柱神经外科,北京100049

出　　处：《中华神经外科杂志》2011年第11期1128-1131,共4页Chinese Journal of Neurosurgery

摘　　要：目的通过对611例脂肪瘤型脊髓栓系综合征临床数据分析评价其显微外科治疗的疗效。方法患者均行神经系统和MRI检查，并经显微外科手术治疗。手术前后相应地应用尿动力学、神经电生理等检查手段。术后疗效根据Hoffman功能性分级、Kirollos术中松解分级、尿动力学和神经电生理等结果进行评定。结果根据Hoffman功能性分级：术后无症状87例（14．2％），轻度289例（47．3％），中度214例（35．1％），重度21例（3．4％）。按Kirollos术中松解分级评定方法：587例（96．0％）达到I级，16例（2．6％）达到Ⅱ级，8例（1．3％）为Ⅲ级。尿动力学检查在术前和术后差异有统计学意义。神经电生理检查在术前和术后差异有统计学意义。结论显微外科手术治疗脂肪瘤型脊髓栓系综合征可获得较好的疗效，尿动力学以及神经电生理的临床应用可以提高疗效。Objective To study the therapeutic effects of microsurgery for lipoma tethered cord syndrome. Method The clinical data of 611 patients with lipoma tethered cord syndrome were studied. The examination in nervous system and MRI were conducted. The microsurgical treatment of lipoma tethered cord syndrome was performed in all cases and the therapeutic effectiveness after operation was analyzed according to Hoffman grading system, Kirollos grading system, urodynamical examination and electrophysiological examination. Results According to Hoffman grading system, 87 patients were asymptomatic, 289 mild, 214 moderate and 21 severe. The degree of untethering was based on Kirollos grading system： Grade I in 587 cases（96. 0% ）, Grade II in 16 （2. 6% ） and Grade 111 in 8 （ 1.3% ）. Recent curative effectiveness in 611 patients was recorded,among them 89 cases（ 14. 6% ） excellent, 381 （62.4%） effective,136（22. 3% ） not changed and 5 （0. 98% ）aggravated. There were significant differences in urodynamical examination and electrophysiological examination between preoperation and postoperation. Conclusions Tethered cord syndrome should be treated as soon as possible by microsurgery. The clinical practice of urodynamics and neuroelectricity, physiology may be helpful for evaluation of postoperative effects.

关 键 词：神经管缺损 脂肪瘤 脊髓栓系综合征 显微外科手术 神经电生理 尿动力学 

分 类 号：R651.2[医药卫生—外科学]